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Hunter SW, Motala A, Cronin AE, Bartha R, Viana R, Payne MW. Cortical activation during imagined walking for people with lower limb loss: a pilot study. Front Hum Neurosci 2023; 17:1163526. [PMID: 37476004 PMCID: PMC10354232 DOI: 10.3389/fnhum.2023.1163526] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/22/2023] [Indexed: 07/22/2023] Open
Abstract
Each year in Canada, a substantial number of adults undergo limb amputation, with lower limb amputation (LLA) the most prevalent. Enhancing walking ability is crucial for optimizing rehabilitation outcomes, promoting participation, and facilitating community reintegration. Overcoming challenges during the acute post-amputation phase and sub-acute rehabilitation necessitates alternative approaches, such as motor imagery and mental practice, to maximize rehabilitation success. However, the current evidence on activation patterns using motor imagery in individuals with LLA is limited. The primary objective was to assess the feasibility of observing brain activation during imagined walking in individuals with LLA utilizing 3T functional magnetic resonance imaging (fMRI). Eight individuals with LLA and 11 control subjects participated. Consistent with representations of the lower limbs, both control and amputee groups demonstrated bilateral activation in the medial surface of the primary motor and somatosensory cortices. However, individuals with lower limb amputations exhibited significantly greater activation during imagined walking, particularly in frontal regions and the medial surface of the primary motor and supplementary motor cortices. Furthermore, the volume of activation in the bilateral primary motor cortices was higher for participants with amputations compared to controls. The protocol developed in this study establishes a foundation for evaluating the effects of a gait training program that incorporates mental imagery alongside conventional rehabilitation practices, in contrast to standard care alone. This pilot investigation holds potential to enhance our understanding of brain plasticity in individuals with LLA and pave the way for more effective rehabilitation strategies to optimize functional recovery and community reintegration.
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Affiliation(s)
- Susan W. Hunter
- School of Physical Therapy, The University of Western Ontario, London, ON, Canada
| | - Aysha Motala
- School of Psychology, The University of Stirling, Stirling, Scotland
| | - Alicia E. Cronin
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, The University of Western Ontario, London, ON, Canada
| | - Robert Bartha
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, The University of Western Ontario, London, ON, Canada
| | - Ricardo Viana
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
| | - Michael W. Payne
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
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Cabaraux P, Agrawal SK, Cai H, Calabro RS, Casali C, Damm L, Doss S, Habas C, Horn AKE, Ilg W, Louis ED, Mitoma H, Monaco V, Petracca M, Ranavolo A, Rao AK, Ruggieri S, Schirinzi T, Serrao M, Summa S, Strupp M, Surgent O, Synofzik M, Tao S, Terasi H, Torres-Russotto D, Travers B, Roper JA, Manto M. Consensus Paper: Ataxic Gait. CEREBELLUM (LONDON, ENGLAND) 2022; 22:394-430. [PMID: 35414041 DOI: 10.1007/s12311-022-01373-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 12/19/2022]
Abstract
The aim of this consensus paper is to discuss the roles of the cerebellum in human gait, as well as its assessment and therapy. Cerebellar vermis is critical for postural control. The cerebellum ensures the mapping of sensory information into temporally relevant motor commands. Mental imagery of gait involves intrinsically connected fronto-parietal networks comprising the cerebellum. Muscular activities in cerebellar patients show impaired timing of discharges, affecting the patterning of the synergies subserving locomotion. Ataxia of stance/gait is amongst the first cerebellar deficits in cerebellar disorders such as degenerative ataxias and is a disabling symptom with a high risk of falls. Prolonged discharges and increased muscle coactivation may be related to compensatory mechanisms and enhanced body sway, respectively. Essential tremor is frequently associated with mild gait ataxia. There is growing evidence for an important role of the cerebellar cortex in the pathogenesis of essential tremor. In multiple sclerosis, balance and gait are affected due to cerebellar and spinal cord involvement, as a result of disseminated demyelination and neurodegeneration impairing proprioception. In orthostatic tremor, patients often show mild-to-moderate limb and gait ataxia. The tremor generator is likely located in the posterior fossa. Tandem gait is impaired in the early stages of cerebellar disorders and may be particularly useful in the evaluation of pre-ataxic stages of progressive ataxias. Impaired inter-joint coordination and enhanced variability of gait temporal and kinetic parameters can be grasped by wearable devices such as accelerometers. Kinect is a promising low cost technology to obtain reliable measurements and remote assessments of gait. Deep learning methods are being developed in order to help clinicians in the diagnosis and decision-making process. Locomotor adaptation is impaired in cerebellar patients. Coordinative training aims to improve the coordinative strategy and foot placements across strides, cerebellar patients benefiting from intense rehabilitation therapies. Robotic training is a promising approach to complement conventional rehabilitation and neuromodulation of the cerebellum. Wearable dynamic orthoses represent a potential aid to assist gait. The panel of experts agree that the understanding of the cerebellar contribution to gait control will lead to a better management of cerebellar ataxias in general and will likely contribute to use gait parameters as robust biomarkers of future clinical trials.
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Affiliation(s)
- Pierre Cabaraux
- Unité Des Ataxies Cérébelleuses, Department of Neurology, CHU de Charleroi, Charleroi, Belgium.
| | | | - Huaying Cai
- Department of Neurology, Neuroscience Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, China
| | | | - Carlo Casali
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy
| | - Loic Damm
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
| | - Sarah Doss
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, USA
| | - Christophe Habas
- Université Versailles Saint-Quentin, Versailles, France.,Service de NeuroImagerie, Centre Hospitalier National des 15-20, Paris, France
| | - Anja K E Horn
- Institute of Anatomy and Cell Biology I, Ludwig Maximilians-University Munich, Munich, Germany
| | - Winfried Ilg
- Section Computational Sensomotorics, Hertie Institute for Clinical Brain Research, University Tübingen, Tübingen, Germany
| | - Elan D Louis
- Department of Neurology, University of Texas Southwestern, Dallas, TX, USA
| | - Hiroshi Mitoma
- Department of Medical Education, Tokyo Medical University, Tokyo, Japan
| | - Vito Monaco
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Maria Petracca
- Department of Human Neurosciences, University of Rome Sapienza, Rome, Italy
| | - Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy
| | - Ashwini K Rao
- Department of Rehabilitation & Regenerative Medicine (Programs in Physical Therapy), Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Serena Ruggieri
- Department of Human Neurosciences, University of Rome Sapienza, Rome, Italy.,Neuroimmunology Unit, IRCSS Fondazione Santa Lucia, Rome, Italy
| | - Tommaso Schirinzi
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Mariano Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy.,Movement Analysis LAB, Policlinico Italia, Rome, Italy
| | - Susanna Summa
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy
| | - Michael Strupp
- Department of Neurology and German Center for Vertigo and Balance Disorders, Hospital of the Ludwig Maximilians-University Munich, Munich, Germany
| | - Olivia Surgent
- Neuroscience Training Program and Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Matthis Synofzik
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research and Centre of Neurology, Tübingen, Germany
| | - Shuai Tao
- Dalian Key Laboratory of Smart Medical and Health, Dalian University, Dalian, 116622, China
| | - Hiroo Terasi
- Department of Neurology, Tokyo Medical University, Tokyo, Japan
| | - Diego Torres-Russotto
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, USA
| | - Brittany Travers
- Department of Kinesiology and Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Jaimie A Roper
- School of Kinesiology, Auburn University, Auburn, AL, USA
| | - Mario Manto
- Unité Des Ataxies Cérébelleuses, Department of Neurology, CHU de Charleroi, Charleroi, Belgium.,Service Des Neurosciences, University of Mons, UMons, Mons, Belgium
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Putzolu M, Samogin J, Cosentino C, Mezzarobba S, Bonassi G, Lagravinese G, Vato A, Mantini D, Avanzino L, Pelosin E. Neural oscillations during motor imagery of complex gait: an HdEEG study. Sci Rep 2022; 12:4314. [PMID: 35279682 PMCID: PMC8918338 DOI: 10.1038/s41598-022-07511-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 01/20/2022] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to investigate differences between usual and complex gait motor imagery (MI) task in healthy subjects using high-density electroencephalography (hdEEG) with a MI protocol. We characterized the spatial distribution of α- and β-bands oscillations extracted from hdEEG signals recorded during MI of usual walking (UW) and walking by avoiding an obstacle (Dual-Task, DT). We applied a source localization algorithm to brain regions selected from a large cortical-subcortical network, and then we analyzed α and β bands Event-Related Desynchronizations (ERDs). Nineteen healthy subjects visually imagined walking on a path with (DT) and without (UW) obstacles. Results showed in both gait MI tasks, α- and β-band ERDs in a large cortical-subcortical network encompassing mostly frontal and parietal regions. In most of the regions, we found α- and β-band ERDs in the DT compared with the UW condition. Finally, in the β band, significant correlations emerged between ERDs and scores in imagery ability tests. Overall we detected MI gait-related α- and β-band oscillations in cortical and subcortical areas and significant differences between UW and DT MI conditions. A better understanding of gait neural correlates may lead to a better knowledge of pathophysiology of gait disturbances in neurological diseases.
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Brain Symmetry Analysis during the Use of a BCI Based on Motor Imagery for the Control of a Lower-Limb Exoskeleton. Symmetry (Basel) 2021. [DOI: 10.3390/sym13091746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Brain–Computer Interfaces (BCI) are systems that allow external devices to be controlled by means of brain activity. There are different such technologies, and electroencephalography (EEG) is an example. One of the most common EEG control methods is based on detecting changes in sensorimotor rhythms (SMRs) during motor imagery (MI). The aim of this study was to assess the laterality of cortical function when performing MI of the lower limb. Brain signals from five subjects were analyzed in two conditions, during exoskeleton-assisted gait and while static. Three different EEG electrode configurations were evaluated: covering both hemispheres, covering the non-dominant hemisphere and covering the dominant hemisphere. In addition, the evolution of performance and laterality with practice was assessed. Although sightly superior results were achieved with information from all electrodes, differences between electrode configurations were not statistically significant. Regarding the evolution during the experimental sessions, the performance of the BCI generally evolved positively the higher the experience was.
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Behavioral and Neural Evidence of the Rewarding Value of Exercise Behaviors: A Systematic Review. Sports Med 2018; 48:1389-1404. [PMID: 29556981 DOI: 10.1007/s40279-018-0898-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND In a time of physical inactivity pandemic, attempts to better understand the factors underlying the regulation of exercise behavior are important. The dominant neurobiological approach to exercise behavior considers physical activity to be a reward; however, negative affective responses during exercise challenge this idea. OBJECTIVE Our objective was to systematically review studies testing the automatic reactions triggered by stimuli associated with different types of exercise behavior (e.g. physical activity, sedentary behaviors) and energetic cost variations (e.g. decreased energetic cost, irrespective of the level of physical activity). We also examined evidence supporting the hypothesis that behaviors minimizing energetic cost (BMEC) are rewarding. METHODS Two authors systematically searched, screened, extracted, and analyzed data from articles in the MEDLINE database. RESULTS We included 26 studies. Three outcomes of automatic processes were tested: affective reactions, attentional capture, and approach tendencies. Behavioral results show that physical activity can become attention-grabbing, automatically trigger positive affect, and elicit approach behaviors. These automatic reactions explain and predict exercise behaviors; however, the use of a wide variety of measures prevents drawing solid conclusions about the specific effects of automatic processes. Brain imaging results are scarce but show that stimuli associated with physical activity and, to a lesser extent, sedentary behaviors activate regions involved in reward processes. Studies investigating the rewarding value of behaviors driving energetic cost variations such as BMEC are lacking. CONCLUSION Reward is an important factor in exercise behavior. The literature based on the investigation of automatic behaviors seems in line with the suggestion that physical activity is rewarding, at least for physically active individuals. Results suggest that sedentary behaviors could also be rewarding, although this evidence remains weak due to a lack of investigations. Finally, from an evolutionary perspective, BMEC are likely to be rewarding; however, no study has investigated this hypothesis. In sum, additional studies are required to establish a strong and complete framework of the reward processes underlying automatic exercise behavior.
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Marrus N, Eggebrecht AT, Todorov A, Elison JT, Wolff JJ, Cole L, Gao W, Pandey J, Shen MD, Swanson MR, Emerson RW, Klohr CL, Adams CM, Estes AM, Zwaigenbaum L, Botteron KN, McKinstry RC, Constantino JN, Evans AC, Hazlett HC, Dager SR, Paterson SJ, Schultz RT, Styner MA, Gerig G, Schlaggar BL, Piven J, Pruett JR. Walking, Gross Motor Development, and Brain Functional Connectivity in Infants and Toddlers. Cereb Cortex 2018; 28:750-763. [PMID: 29186388 PMCID: PMC6057546 DOI: 10.1093/cercor/bhx313] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 10/29/2017] [Accepted: 11/01/2017] [Indexed: 11/14/2022] Open
Abstract
Infant gross motor development is vital to adaptive function and predictive of both cognitive outcomes and neurodevelopmental disorders. However, little is known about neural systems underlying the emergence of walking and general gross motor abilities. Using resting state fcMRI, we identified functional brain networks associated with walking and gross motor scores in a mixed cross-sectional and longitudinal cohort of infants at high and low risk for autism spectrum disorder, who represent a dimensionally distributed range of motor function. At age 12 months, functional connectivity of motor and default mode networks was correlated with walking, whereas dorsal attention and posterior cingulo-opercular networks were implicated at age 24 months. Analyses of general gross motor function also revealed involvement of motor and default mode networks at 12 and 24 months, with dorsal attention, cingulo-opercular, frontoparietal, and subcortical networks additionally implicated at 24 months. These findings suggest that changes in network-level brain-behavior relationships underlie the emergence and consolidation of walking and gross motor abilities in the toddler period. This initial description of network substrates of early gross motor development may inform hypotheses regarding neural systems contributing to typical and atypical motor outcomes, as well as neurodevelopmental disorders associated with motor dysfunction.
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Affiliation(s)
- Natasha Marrus
- Department of Psychiatry,Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Adam T Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Alexandre Todorov
- Department of Psychiatry,Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455,USA
| | - Jason J Wolff
- Department of Educational Psychology,University of Minnesota, 56 East River Road, Minneapolis, MN 55455, USA
| | - Lyndsey Cole
- Department of Psychiatry,Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Wei Gao
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048, USA
| | - Juhi Pandey
- Children’s Hospital of Philadelphia,University of Pennsylvania, Civic Center Blvd, Philadelphia, PA 19104,USA
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA
| | - Meghan R Swanson
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA
| | - Robert W Emerson
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA
| | - Cheryl L Klohr
- Department of Psychiatry,Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Chloe M Adams
- Department of Psychiatry,Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Annette M Estes
- Department of Speech and Hearing Sciences, University of Washington, 1701 NE Columbia Rd., Seattle, WA 98195-7920, USA
| | - Lonnie Zwaigenbaum
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Centre (WMC), 8440 112 St NW, Edmonton, Alberta, Canada T6G 2B7
| | - Kelly N Botteron
- Department of Psychiatry,Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Robert C McKinstry
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - John N Constantino
- Department of Psychiatry,Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
| | - Alan C Evans
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, 3801 University St, Montreal, Quebec, Canada H3A 2B4
| | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA
| | - Stephen R Dager
- Department of Radiology, University of Washington, 1410 NE Campus Parkway, Seattle, WA 98195,USA
| | - Sarah J Paterson
- Department of Psychology, Temple University, 1801 N. Broad St., Philadelphia, PA 19122,USA
| | - Robert T Schultz
- Children’s Hospital of Philadelphia,University of Pennsylvania, Civic Center Blvd, Philadelphia, PA 19104,USA
| | - Martin A Styner
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA
| | - Guido Gerig
- Tandon School of Engineering, New York University, 6 Metro Tech Center, Brooklyn, NY 11201, USA
| | | | - Bradley L Schlaggar
- Department of Neurology, Washington University School of Medicine, 660 S. Euclid Ave, St Louis, MO 63110,USA
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA
| | - John R Pruett
- Department of Psychiatry,Washington University School of Medicine, 660 S Euclid Ave, St Louis, MO 63110, USA
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Abstract
The vestibular cortex differs in various ways from other sensory cortices. It consists of a network of several distinct and separate temporoparietal areas. Its core region, the parietoinsular vestibular cortex (PIVC), is located in the posterior insula and retroinsular region and includes the parietal operculum. The entire network is multisensory (in particular, vestibular, visual, and somatosensory). The peripheral and central vestibular systems are bilaterally organized; there are various pontomesencephalic brainstem crossings and at least two transcallosal connections of both hemispheres, between the PIVC and the motion-sensitive visual cortex areas, which also mediate vestibular input. Structural and functional vestibular dominance characterizes the right hemisphere in right-handers and the left hemisphere in left-handers. This explains why right-hemispheric lesions in right-handers more often generally cause hemispatial neglect and the pusher syndrome, both of which involve vestibular function. Vestibular input also contributes to cognition and may determine individual lateralization of brain functions such as handedness. Bilateral organization is a major key to understanding cortical functions and disorders, for example, the visual-vestibular interaction that occurs in spatial orientation. Although the vestibular cortex is represented in both hemispheres, there is only one global percept of body position and motion. The chiefly vestibular aspects of the multiple functions and disorders of the parietal lobe dealt with in this chapter cannot be strictly separated from various multisensory vestibular functions within the entire brain.
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Affiliation(s)
- Marianne Dieterich
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany; German Center for Vertigo and Balance Disorders-IFB, Ludwig-Maximilians-University, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
| | - Thomas Brandt
- German Center for Vertigo and Balance Disorders-IFB, Ludwig-Maximilians-University, Munich, Germany; Clinical Neuroscience, Ludwig-Maximilians-University, Munich, Germany
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Marusic U, Giordani B, Moffat SD, Petrič M, Dolenc P, Pišot R, Kavcic V. Computerized cognitive training during physical inactivity improves executive functioning in older adults. AGING NEUROPSYCHOLOGY AND COGNITION 2016; 25:49-69. [PMID: 27937138 DOI: 10.1080/13825585.2016.1263724] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The hippocampus is closely tied to spatial navigation, a central component in cognitive functioning, and critically involved in age-associated cognitive decline and dementia. This study evaluated a novel, cognitive computerized spatial navigation training (CSNT) program targeting the hippocampus, with expectation of mitigating possible cognitive decline with bed rest (BR). During a 14-day BR study with 16 healthy, older men (mean age = 60 ± 3, range = 55-65 years), half received CSNT for 12 days in 50-min sessions and half were controls (watching documentaries). This design uniquely controlled diet, sleep, and other personal and environmental activities. Although there were no cognitive declines in controls post-BR, CSNT participants demonstrated significant increases in executive/attention ability and processing speed, and continued spatial navigation testing showed improvement to 400 days post-BR. This intervention may prove useful to mitigate cognitive declines known to occur in long periods of immobilization and could have broader implications in protecting against age-related cognitive decline.
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Affiliation(s)
- Uros Marusic
- a Institute for Kinesiology Research, Science and Research Centre , University of Primorska , Koper , Slovenia
| | - Bruno Giordani
- b Departments of Psychiatry, Neurology, and Psychology and School of Nursing , University of Michigan , Ann Arbor , MI , USA
| | - Scott D Moffat
- c School of Psychology , Georgia Institute of Technology , Atlanta , GA , USA
| | - Mojca Petrič
- d Faculty of Education , University of Primorska , Koper , Slovenia
| | - Petra Dolenc
- d Faculty of Education , University of Primorska , Koper , Slovenia
| | - Rado Pišot
- a Institute for Kinesiology Research, Science and Research Centre , University of Primorska , Koper , Slovenia
| | - Voyko Kavcic
- e Institute of Gerontology , Wayne State University , Detroit , MI , USA
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Delval A, Tard C, Rambour M, Defebvre L, Moreau C. Characterization and quantification of freezing of gait in Parkinson's disease: Can detection algorithms replace clinical expert opinion? Neurophysiol Clin 2015; 45:305-13. [PMID: 26547546 DOI: 10.1016/j.neucli.2015.09.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 09/16/2015] [Accepted: 09/16/2015] [Indexed: 10/22/2022] Open
Abstract
Freezing of gait is a paroxysmal phenomenon that is frequently reported by the parkinsonian patients or their entourage. The phenomenon significantly alters quality of life but is often difficult to characterize in the physician's office. In the present review, we focus on the clinical characterization and quantification of freezing of gait. Various biomechanical methods (based mainly on time-frequency analysis) can be used to determine time-domain characteristics of freezing of gait. Methods already used to study non-gait freezing of other effectors (the lower limbs, upper limbs and orofacial area) are also being developed for the analysis of freezing in functional magnetic resonance imaging protocols. Here, we review the reliability of these methods and compare them with reliability of information obtained from physical examination and detailed analysis of the patient's medical history.
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Affiliation(s)
- A Delval
- U1171, Université de Lille, Lille, France; Clinical Neurophysiology Department, Lille University Medical Center, Lille, France.
| | - C Tard
- U1171, Université de Lille, Lille, France; Clinical Neurophysiology Department, Lille University Medical Center, Lille, France; Neurology and Movement Disorders Department, Lille University Medical Center, Lille, France
| | - M Rambour
- U1171, Université de Lille, Lille, France; Neurology and Movement Disorders Department, Lille University Medical Center, Lille, France
| | - L Defebvre
- U1171, Université de Lille, Lille, France; Neurology and Movement Disorders Department, Lille University Medical Center, Lille, France
| | - C Moreau
- U1171, Université de Lille, Lille, France; Neurology and Movement Disorders Department, Lille University Medical Center, Lille, France
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10
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Tard C, Delval A, Devos D, Lopes R, Lenfant P, Dujardin K, Hossein-Foucher C, Semah F, Duhamel A, Defebvre L, Le Jeune F, Moreau C. Brain metabolic abnormalities during gait with freezing in Parkinson’s disease. Neuroscience 2015; 307:281-301. [DOI: 10.1016/j.neuroscience.2015.08.063] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 08/25/2015] [Accepted: 08/25/2015] [Indexed: 11/28/2022]
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11
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Maillet A, Thobois S, Fraix V, Redouté J, Le Bars D, Lavenne F, Derost P, Durif F, Bloem BR, Krack P, Pollak P, Debû B. Neural substrates of levodopa-responsive gait disorders and freezing in advanced Parkinson's disease: a kinesthetic imagery approach. Hum Brain Mapp 2015; 36:959-80. [PMID: 25411130 PMCID: PMC6869751 DOI: 10.1002/hbm.22679] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 07/18/2014] [Accepted: 10/21/2014] [Indexed: 11/06/2022] Open
Abstract
Gait disturbances, including freezing of gait, are frequent and disabling symptoms of Parkinson's disease. They often respond poorly to dopaminergic treatments. Although recent studies have shed some light on their neural correlates, their modulation by dopaminergic treatment remains quite unknown. Specifically, the influence of levodopa on the networks involved in motor imagery (MI) of parkinsonian gait has not been directly studied, comparing the off and on medication states in the same patients. We therefore conducted an [H2 (15) 0] Positron emission tomography study in eight advanced parkinsonian patients (mean disease duration: 12.3 ± 3.8 years) presenting with levodopa-responsive gait disorders and FoG, and eight age-matched healthy subjects. All participants performed three tasks (MI of gait, visual imagery and a control task). Patients were tested off, after an overnight withdrawal of all antiparkinsonian treatment, and on medication, during consecutive mornings. The order of conditions was counterbalanced between subjects and sessions. Results showed that imagined gait elicited activations within motor and frontal associative areas, thalamus, basal ganglia and cerebellum in controls. Off medication, patients mainly activated premotor-parietal and pontomesencephalic regions. Levodopa increased activation in motor regions, putamen, thalamus, and cerebellum, and reduced premotor-parietal and brainstem involvement. Areas activated when patients are off medication may represent compensatory mechanisms. The recruitment of these accessory circuits has also been reported for upper-limb movements in Parkinson's disease, suggesting a partly overlapping pathophysiology between imagined levodopa-responsive gait disorders and appendicular signs. Our results also highlight a possible cerebellar contribution in the pathophysiology of parkinsonian gait disorders through kinesthetic imagery.
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Affiliation(s)
- Audrey Maillet
- Université Joseph FourierGrenoble UniversitésGrenobleFrance
- INSERM‐UJF‐CEA‐CHU U836 Grenoble Institut des NeurosciencesGrenobleFrance
- Centre de Neuroscience CognitiveUMR 5229 CNRSLyonFrance
| | - Stéphane Thobois
- Centre de Neuroscience CognitiveUMR 5229 CNRSLyonFrance
- Hospices Civils de LyonHôpital Neurologique Pierre WertheimerLyonFrance
- Faculté de médecine Lyon Sud Charles MérieuxUniversité Lyon ILyonFrance
| | - Valérie Fraix
- Université Joseph FourierGrenoble UniversitésGrenobleFrance
- INSERM‐UJF‐CEA‐CHU U836 Grenoble Institut des NeurosciencesGrenobleFrance
- Centre Hospitalier UniversitairePavillon de NeurologieGrenobleFrance
| | | | - Didier Le Bars
- Hospices Civils de LyonHôpital Neurologique Pierre WertheimerLyonFrance
- CERMEPImagerie du VivantBronFrance
- Institut de Chimie et Biochimie Moléculaires et SupramoléculairesUniversité Claude BernardLyon ILyonFrance
| | | | - Philippe Derost
- Hôpital Gabriel MontpiedService de NeurologieClermont‐FerrandFrance
| | - Franck Durif
- Hôpital Gabriel MontpiedService de NeurologieClermont‐FerrandFrance
| | - Bastiaan R. Bloem
- Radboud University Medical CenterDonders Institute for BrainCognition and BehaviorDepartment of NeurologyNijmegenNetherlands
| | - Paul Krack
- Université Joseph FourierGrenoble UniversitésGrenobleFrance
- INSERM‐UJF‐CEA‐CHU U836 Grenoble Institut des NeurosciencesGrenobleFrance
- Centre Hospitalier UniversitairePavillon de NeurologieGrenobleFrance
| | - Pierre Pollak
- Université Joseph FourierGrenoble UniversitésGrenobleFrance
- INSERM‐UJF‐CEA‐CHU U836 Grenoble Institut des NeurosciencesGrenobleFrance
- Centre Hospitalier UniversitairePavillon de NeurologieGrenobleFrance
- Hôpitaux Universitaires de GenèveGenevaSwitzerland
| | - Bettina Debû
- Université Joseph FourierGrenoble UniversitésGrenobleFrance
- INSERM‐UJF‐CEA‐CHU U836 Grenoble Institut des NeurosciencesGrenobleFrance
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12
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Peterson DS, Pickett KA, Duncan RP, Perlmutter JS, Earhart GM. Brain activity during complex imagined gait tasks in Parkinson disease. Clin Neurophysiol 2014; 125:995-1005. [PMID: 24210997 PMCID: PMC3981914 DOI: 10.1016/j.clinph.2013.10.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Revised: 09/24/2013] [Accepted: 10/01/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Motor imagery during functional magnetic resonance imaging (fMRI) allows assessment of brain activity during tasks, like walking, that cannot be completed in an MRI scanner. We used gait imagery to assess the neural pathophysiology of locomotion in Parkinson disease (PD). METHODS Brain activity was measured in five locomotor regions (supplementary motor area (SMA), globus pallidus (GP), putamen, mesencephalic locomotor region, cerebellar locomotor region) during simple (forward) and complex (backward, turning) gait imagery. Brain activity was correlated to overground walking velocity. RESULTS Across tasks, PD exhibited reduced activity in the globus pallidus compared to controls. People with PD, but not controls, exhibited more activity in the SMA during imagined turning compared to forward or backward walking. In PD, walking speed was correlated to brain activity in several regions. CONCLUSIONS Altered SMA activity in PD during imagined turning may represent compensatory neural adaptations during complex gait. The lowered activity and positive correlation to locomotor function in GP suggests reduced activity in this region may relate to locomotor dysfunction. SIGNIFICANCE This study elucidates changes in neural activity during gait in PD, underscoring the importance of testing simple and complex tasks. Results support a positive relationship between activity in locomotor regions and walking ability.
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Affiliation(s)
- Daniel S Peterson
- Program in Physical Therapy, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States.
| | - Kristen A Pickett
- Program in Physical Therapy, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States; Department of Neurology, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States.
| | - Ryan P Duncan
- Program in Physical Therapy, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States.
| | - Joel S Perlmutter
- Program in Physical Therapy, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States; Department of Neurology, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States; Department of Neurobiology, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States; Department of Radiology, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States; Program in Occupational Therapy, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States.
| | - Gammon M Earhart
- Program in Physical Therapy, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States; Department of Neurology, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States; Department of Neurobiology, Washington University in St. Louis, 660 S. Euclid, St. Louis, MO 63110, United States.
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13
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Peterson DS, Pickett KA, Duncan R, Perlmutter J, Earhart GM. Gait-related brain activity in people with Parkinson disease with freezing of gait. PLoS One 2014; 9:e90634. [PMID: 24595265 PMCID: PMC3940915 DOI: 10.1371/journal.pone.0090634] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 02/05/2014] [Indexed: 11/18/2022] Open
Abstract
Approximately 50% of people with Parkinson disease experience freezing of gait, described as a transient inability to produce effective stepping. Complex gait tasks such as turning typically elicit freezing more commonly than simple gait tasks, such as forward walking. Despite the frequency of this debilitating and dangerous symptom, the brain mechanisms underlying freezing remain unclear. Gait imagery during functional magnetic resonance imaging permits investigation of brain activity associated with locomotion. We used this approach to better understand neural function during gait-like tasks in people with Parkinson disease who experience freezing--"FoG+" and people who do not experience freezing--"FoG-". Nine FoG+ and nine FoG- imagined complex gait tasks (turning, backward walking), simple gait tasks (forward walking), and quiet standing during measurements of blood oxygen level dependent (BOLD) signal. Changes in BOLD signal (i.e. beta weights) during imagined walking and imagined standing were analyzed across FoG+ and FoG- groups in locomotor brain regions including supplementary motor area, globus pallidus, putamen, mesencephalic locomotor region, and cerebellar locomotor region. Beta weights in locomotor regions did not differ for complex tasks compared to simple tasks in either group. Across imagined gait tasks, FoG+ demonstrated significantly lower beta weights in the right globus pallidus with respect to FoG-. FoG+ also showed trends toward lower beta weights in other right-hemisphere locomotor regions (supplementary motor area, mesencephalic locomotor region). Finally, during imagined stand, FoG+ exhibited lower beta weights in the cerebellar locomotor region with respect to FoG-. These data support previous results suggesting FoG+ exhibit dysfunction in a number of cortical and subcortical regions, possibly with asymmetric dysfunction towards the right hemisphere.
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Affiliation(s)
- Daniel S. Peterson
- Program in Physical Therapy, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Kristen A. Pickett
- Program in Physical Therapy, Washington University in St. Louis, St. Louis, Missouri, United States of America
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Ryan Duncan
- Program in Physical Therapy, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Joel Perlmutter
- Program in Physical Therapy, Washington University in St. Louis, St. Louis, Missouri, United States of America
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, United States of America
- Anatomy and Neurobiology, Washington University in St. Louis, St. Louis, Missouri, United States of America
- Radiology, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Gammon M. Earhart
- Program in Physical Therapy, Washington University in St. Louis, St. Louis, Missouri, United States of America
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, United States of America
- Anatomy and Neurobiology, Washington University in St. Louis, St. Louis, Missouri, United States of America
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14
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Blumen HM, Holtzer R, Brown LL, Gazes Y, Verghese J. Behavioral and neural correlates of imagined walking and walking-while-talking in the elderly. Hum Brain Mapp 2014; 35:4090-104. [PMID: 24522972 DOI: 10.1002/hbm.22461] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 12/27/2013] [Accepted: 12/29/2013] [Indexed: 11/06/2022] Open
Abstract
Cognition is important for locomotion and gait decline increases the risk for morbidity, mortality, cognitive decline, and dementia. Yet, the neural correlates of gait are not well established, because most neuroimaging methods cannot image the brain during locomotion. Imagined gait protocols overcome this limitation. This study examined the behavioral and neural correlates of a new imagined gait protocol that involved imagined walking (iW), imagined talking (iT), and imagined walking-while-talking (iWWT). In Experiment 1, 82 cognitively-healthy older adults (M=80.45) walked (W), iW, walked while talking (WWT) and iWWT. Real and imagined walking task times were strongly correlated, particularly real and imagined dual-task times (WWT and iWWT). In Experiment 2, 33 cognitively-healthy older adults (M=73.03) iW, iT, and iWWT during functional magnetic resonance imaging. A multivariate Ordinal Trend (OrT) Covariance analysis identified a pattern of brain regions that: (1) varied as a function of imagery task difficulty (iW, iT and iWWT), (2) involved cerebellar, precuneus, supplementary motor and other prefrontal regions, and (3) were associated with kinesthetic imagery ratings and behavioral performance during actual WWT. This is the first study to compare the behavioral and neural correlates of imagined gait in single and dual-task situations, an issue that is particularly relevant to elderly populations. These initial findings encourage further research and development of this imagined gait protocol as a tool for improving gait and cognition among the elderly.
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Affiliation(s)
- Helena M Blumen
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
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15
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Hale TS. A distributed effects perspective of dimensionally defined psychiatric disorders: and convergent versus core deficit effects in ADHD. Front Psychiatry 2014; 5:62. [PMID: 24926271 PMCID: PMC4046176 DOI: 10.3389/fpsyt.2014.00062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 05/18/2014] [Indexed: 11/13/2022] Open
Abstract
The focus of psychiatric and psychological research has arguably shifted from brain damage and psychosis to more common forms of psychopathology that reflect extremes variants of otherwise normal cognitive and behavioral characteristics. Now, in addition to trying to understand overtly damaged brain-function (flat tire effects), we are also seeking to understand liabilities associated with non-optimized, but otherwise intact, cognitive and behavioral abilities (poor tuning effects). This shift has pushed us to evolve our investigational strategies to more broadly consider whole-brain integrated brain systems, as well as seek to develop more specific quantifiable indicators of impoverished brain function and behavior. This paper discusses such challenges in relation to dimensionally defined psychiatric disorders and presents a novel whole-brain integrated perspective of ADHD brain function pathology.
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Affiliation(s)
- T Sigi Hale
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior , Los Angeles, CA , USA
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16
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Gabbard CP, Lee J. A Comparison of Movement Imagery Ability Self-Report and Imagery Use in a Motor Task: A Preliminary Investigation. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/jirspa-2014-0006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractThe present study used the Movement Imagery Questionnaire (MIQ-3) to determine the relationship between self-report movement imagery ability and performance on a motor task requiring use of visual and kinesthetic imagery. Young adults were asked to view a number sequence of 4- and 5 digits, maintain the information over a 6 s delay (blank screen) using visual imagery maintenance, and complete the sequence by finger-tapping complementary numbers using motor (kinesthetic) imagery and actually executing movements. We predicted higher movement imagery ability scores would be associated with faster movement times, and imagery ability would be significantly related to the motor tasks. Correlation results indicated no significant differences between self-report and finger-tapping scores, suggesting that in the context of the motor tasks used here, performance was independent of movement imagery ability. Discussion of this preliminary study focuses on the role of visual working memory in the motor task used here and its lack of assessment using the MIQ-3 and other current self-reports.
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Dickstein R, Deutsch JE, Yoeli Y, Kafri M, Falash F, Dunsky A, Eshet A, Alexander N. Effects of Integrated Motor Imagery Practice on Gait of Individuals With Chronic Stroke: A Half-Crossover Randomized Study. Arch Phys Med Rehabil 2013; 94:2119-25. [DOI: 10.1016/j.apmr.2013.06.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 06/24/2013] [Accepted: 06/25/2013] [Indexed: 10/26/2022]
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Crémers J, D'Ostilio K, Stamatakis J, Delvaux V, Garraux G. Brain activation pattern related to gait disturbances in Parkinson's disease. Mov Disord 2012; 27:1498-505. [PMID: 23008169 DOI: 10.1002/mds.25139] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 05/22/2012] [Accepted: 07/12/2012] [Indexed: 12/11/2022] Open
Abstract
Gait disturbances represent a therapeutic challenge in Parkinson's disease (PD). To further investigate their underlying pathophysiological mechanisms, we compared brain activation related to mental imagery of gait between 15 PD patients and 15 age-matched controls using a block-design functional MRI experiment. On average, patients showed altered locomotion relatively to controls, as assessed with a standardized gait test that evaluated the severity of PD-related gait disturbances on a 25-m path. The experiment was conducted in the subjects as they rehearsed themselves walking on the same path with a gait pattern similar as that during locomotor evaluation. Imagined walking times were measured on a trial-by-trial basis as a control of behavioral performance. In both groups, mean imagined walking time was not significantly different from that measured during real gait on the path used for evaluation. The between-group comparison of the mental gait activation pattern with reference to mental imagery of standing showed hypoactivations within parieto-occipital regions, along with the left hippocampus, midline/lateral cerebellum, and presumed pedunculopontine nucleus/mesencephalic locomotor area, in patients. More specifically, the activation level of the right posterior parietal cortex located within the impaired gait-related cognitive network decreased proportionally with the severity of gait disturbances scored on the path used for gait evaluation and mental imagery. These novel findings suggest that the right posterior parietal cortex dysfunction is strongly related to the severity of gait disturbances in PD. This region may represent a target for the development of therapeutic interventions for PD-related gait disturbances.
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Affiliation(s)
- Julien Crémers
- Movere Group, Cyclotron Research Center, University of Liège, Liège, Belgium.
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