Prism adaptation in Parkinson disease: comparing reaching to walking and freezers to non-freezers

Quantifying motor adaptation in a sport-specific table tennis setting

Studies on motor adaptation aim to better understand the remarkable, largely implicit capacity of humans to adjust to changing environmental conditions. So far, this phenomenon has mainly been investigated in highly controlled laboratory setting, allowing only limited conclusions and consequences for everyday life scenarios. Natural movement tasks performed under externally valid conditions would provide important support on the transferability of recent laboratory findings. Therefore, one major goal of the current study was to create and assess a new table tennis paradigm mapping motor adaptation in a more natural and sport-specific setting. High-speed cinematographic measurements were used to determine target accuracy in a motor adaptation table tennis paradigm in 30 right-handed participants. In addition, we investigated if motor adaptation was affected by temporal order of perturbations (serial vs. random practice). In summary, we were able to confirm and reproduce typical motor adaptation effects in a sport-specific setting. We found, according to previous findings, an increase in target errors with perturbation onset that decreased during motor adaptation. Furthermore, we observed an increase in target errors with perturbation offset (after-effect) that decrease subsequently during washout phase. More importantly, this motor adaptation phenomenon did not differ when comparing serial vs. random perturbation conditions.

Slower rates of prism adaptation but intact aftereffects in patients with early to mid-stage Parkinson's disease

There is currently mixed evidence on the effect of Parkinson's disease on motor adaptation. Some studies report that patients display adaptation comparable to age-matched controls, while others report a complete inability to adapt to novel sensory perturbations. Here, early to mid-stage Parkinson's patients were recruited to perform a prism adaptation task. When compared to controls, patients showed slower rates of initial adaptation but intact aftereffects. These results support the suggestion that patients with early to mid-stage Parkinson's disease display intact adaptation driven by sensory prediction errors, as shown by the intact aftereffect. But impaired facilitation of performance through cognitive strategies informed by task error, as shown by the impaired initial adaptation. These results support recent studies that suggest that patients with Parkinson's disease retain the ability to perform visuomotor adaptation, but display altered use of cognitive strategies to aid performance and generalises these previous findings to the classical prism adaptation task.

Cerebellar Volume and Executive Function in Parkinson Disease with and without Freezing of Gait

BACKGROUND

Freezing of gait (FOG) affects approximately 50% of people with Parkinson Disease (PD), impacting quality of life and placing financial and emotional strain on the individual and caregivers. People with PD and FOG have similar deficits in motor adaptation and cognition as individuals with cerebellar lesions, indicating the cerebellum may play a role in FOG.

OBJECTIVE

To examine potential differences in cerebellar volumes and their relationships with cognition between PD with (FOG+) and without FOG (FOG-).

METHODS

Sixty-three participants were divided into two groups, FOG+ (n = 25) and FOG- (n = 38), based on the New Freezing of Gait Questionnaire. Cognitive assessment included Trail Making, Stroop, Verbal Fluency, and Go-NoGo executive function tasks. All participants completed structural T1- and T2-weighted MRI scans. Imaging data were processed with FreeSurfer and the Spatially Unbiased Infratentorial toolbox to segment the cerebellum into individual lobules.

RESULTS

FOG+ performed significantly worse on phonemic verbal fluency (F(1, 22)  =  7.06, p = 0.01) as well as the Go-NoGo task (F(1, 22)  =  9.00, p = 0.004). We found no differences in cerebellar volumes between groups (F(4, 55)  = 1.42, p = 0.24), but there were significant relationships between verbal fluency measures and lobule volumes in FOG-.

CONCLUSIONS

These findings underscore the need for longitudinal studies to better characterize potential changes in cerebellar volume, cognitive function, and functional connectivity between people with PD with and without FOG.

Multi-Trial Gait Adaptation of Healthy Individuals during Visual Kinematic Perturbations

Optimizing rehabilitation strategies requires understanding the effects of contextual cues on adaptation learning. Prior studies have examined these effects on the specificity of split-belt walking adaptation, showing that contextual visual cues can be manipulated to modulate the magnitude, transfer, and washout of split-belt-induced learning in humans. Specifically, manipulating the availability of vision during training or testing phases of learning resulted in differences in adaptive mechanisms for temporal and spatial features of walking. However, multi-trial locomotor training has been rarely explored when using visual kinematic gait perturbations. In this study, we investigated multi-trial locomotor adaptation in ten healthy individuals while applying visual kinematic perturbations. Subjects were instructed to control a moving cursor, which represented the position of their heel, to follow a prescribed heel path profile displayed on a monitor. The perturbations were introduced by scaling all of the lower limb joint angles by a factor of 0.7 (i.e., a gain change), resulting in visual feedback errors between subjects' heel trajectories and the prescribed path profiles. Our findings suggest that, with practice, the subjects learned, albeit with different strategies, to reduce the tracking errors and showed faster response time in later trials. Moreover, the gait symmetry indices, in both the spatial and temporal domains, changed significantly during gait adaptation (P < 0.001). After-effects were present in the temporal gait symmetry index whens the visual perturbations were removed in the post-exposure period (P < 0.001), suggesting adaptation learning. These findings may have implications for developing novel gait rehabilitation interventions.

Inclination of standing posture due to the presentation of tilted view through an immersive head-mounted display

[Purpose] The purpose of the present study is to clarify whether tilted scenery presented through an immersive head-mounted display (HMD) causes the inclination of standing posture. [Subjects and Methods] Eleven healthy young adult males who provided informed consent participated in the experiment. An immersive HMD and a stereo camera were employed to develop a visual inclination system. The subjects maintained a standing posture twice for 5s each while wearing the visual inclination system. They performed this task under two conditions: normal view and 20° leftward tilted view. A three-dimensional motion analysis system was used to measure the subjects’ postures, and two force plates were used to measure the vertical component of the floor reaction force of each leg. [Results] In the 20° leftward tilted view, the head and trunk angles in the frontal plane were similarly inclined toward the left, and the vertical component of the floor reaction force increased in the left leg, whereas it decreased in the right leg. [Conclusion] When the view in the immersive HMD was tilted, the participants’ trunk side bent toward the same side as that of the view. This visual inclination system seems to be a simple intervention for changing standing posture.