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Sozzi S, Ghai S, Schieppati M. The 'Postural Rhythm' of the Ground Reaction Force during Upright Stance and Its Conversion to Body Sway-The Effect of Vision, Support Surface and Adaptation to Repeated Trials. Brain Sci 2023; 13:978. [PMID: 37508910 PMCID: PMC10377030 DOI: 10.3390/brainsci13070978] [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: 05/11/2023] [Revised: 06/12/2023] [Accepted: 06/18/2023] [Indexed: 07/30/2023] Open
Abstract
The ground reaction force (GRF) recorded by a platform when a person stands upright lies at the interface between the neural networks controlling stance and the body sway deduced from centre of pressure (CoP) displacement. It can be decomposed into vertical (VGRF) and horizontal (HGRF) vectors. Few studies have addressed the modulation of the GRFs by the sensory conditions and their relationship with body sway. We reconsidered the features of the GRFs oscillations in healthy young subjects (n = 24) standing for 90 s, with the aim of characterising the possible effects of vision, support surface and adaptation to repeated trials, and the correspondence between HGRF and CoP time-series. We compared the frequency spectra of these variables with eyes open or closed on solid support surface (EOS, ECS) and on foam (EOF, ECF). All stance trials were repeated in a sequence of eight. Conditions were randomised across different days. The oscillations of the VGRF, HGRF and CoP differed between each other, as per the dominant frequency of their spectra (around 4 Hz, 0.8 Hz and <0.4 Hz, respectively) featuring a low-pass filter effect from VGRF to HGRF to CoP. GRF frequencies hardly changed as a function of the experimental conditions, including adaptation. CoP frequencies diminished to <0.2 Hz when vision was available on hard support surface. Amplitudes of both GRFs and CoP oscillations decreased in the order ECF > EOF > ECS ≈ EOS. Adaptation had no effect except in ECF condition. Specific rhythms of the GRFs do not transfer to the CoP frequency, whereas the magnitude of the forces acting on the ground ultimately determines body sway. The discrepancies in the time-series of the HGRF and CoP oscillations confirm that the body's oscillation mode cannot be dictated by the inverted pendulum model in any experimental conditions. The findings emphasise the robustness of the VGRF "postural rhythm" and its correspondence with the cortical theta rhythm, shed new insight on current principles of balance control and on understanding of upright stance in healthy and elderly people as well as on injury prevention and rehabilitation.
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Affiliation(s)
| | - Shashank Ghai
- Department of Political, Historical, Religious and Cultural Studies, Karlstad University, 65188 Karlstad, Sweden
- Centre for Societal Risk Research, Karlstad University, 65188 Karlstad, Sweden
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2
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Dalla Bella S. Rhythmic serious games as an inclusive tool for music-based interventions. Ann N Y Acad Sci 2022; 1517:15-24. [PMID: 35976673 DOI: 10.1111/nyas.14878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Technologies, such as mobile devices or sets of connected sensors, provide new and engaging opportunities to devise music-based interventions. Among the different technological options, serious games offer a valuable alternative. Serious games can engage multisensory processes, creating a rich, rewarding, and motivating rehabilitation setting. Moreover, they can be targeted to specific musical features, such as pitch production or synchronization to a beat. Because serious games are typically low cost and enjoy wide access, they are inclusive tools perfectly suited for remote at-home interventions using music in various patient populations and environments. The focus of this article is in particular on the use of rhythmic serious games for training auditory-motor synchronization. After reviewing the existing rhythmic games, initial evidence from a recent proof-of-concept study in Parkinson's disease is provided. It is shown that rhythmic video games using finger tapping can be used with success as an at-home protocol, and bring about beneficial effects on motor performance in patients. The use and benefits of rhythmic serious games can extend beyond the rehabilitation of patients with movement disorders, such as to neurodevelopmental disorders, including dyslexia and autism spectrum disorder.
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Affiliation(s)
- Simone Dalla Bella
- International Laboratory for Brain, Music, and Sound Research (BRAMS), Montreal, Quebec, Canada.,Department of Psychology, University of Montreal, Montreal, Quebec, Canada.,Centre for Research on Brain, Language and Music (CRBLM), Montreal, Quebec, Canada.,University of Economics and Human Sciences in Warsaw, Warsaw, Poland
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3
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Puyjarinet F, Bégel V, Geny C, Driss V, Cuartero MC, De Cock VC, Pinto S, Dalla Bella S. At-Home Training With a Rhythmic Video Game for Improving Orofacial, Manual, and Gait Abilities in Parkinson’s Disease: A Pilot Study. Front Neurosci 2022; 16:874032. [PMID: 35769698 PMCID: PMC9235408 DOI: 10.3389/fnins.2022.874032] [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: 02/11/2022] [Accepted: 05/12/2022] [Indexed: 01/10/2023] Open
Abstract
Rhythm disorders are consistently reported in Parkinson’s disease (PD). They manifest across motor domains, such as in orofacial (oral diadochokinesis), manual (finger tapping), and gait tasks. It is still unclear, however, whether these disorders are domain- and task-specific, or result from impaired common mechanisms supporting rhythm processing (general dysrhythmia). We tested the possibility that an at-home intervention delivered via a rhythmic video game on tablet improves motor performance across motor domains in PD. Patients with PD (n = 12) played at home a rhythmic video game (Rhythm Workers) on tablet, in which they finger-tapped to the beat of music, for 6 weeks. A control group (n = 11) played an active non-rhythmic video game (Tetris). A third group (n = 10) did not receive any intervention. We measured rhythmic abilities in orofacial, manual and gait motor domains, as well as rhythm perception, before and after the intervention. Patients who performed the rhythmic training improved their orofacial and manual rhythmic performance. This beneficial effect was linked to improved rhythm perception only following the rhythmic training period. We did not observe any improvement in rhythmic abilities in the other two groups. In this pilot study, we demonstrated that at-home intervention with a rhythmic video game using finger tapping can have beneficial effects on motor performance across different motor domains (manual and orofacial). This finding provides evidence of a general dysrhythmia in PD and paves the way to technology-driven interventions aiming at alleviating rhythm-related motor deficits in PD.
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Affiliation(s)
- Frédéric Puyjarinet
- University of Montpellier, Montpellier, France
- *Correspondence: Frédéric Puyjarinet,
| | - Valentin Bégel
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Christian Geny
- Department of Geriatrics, CHRU of Montpellier, Montpellier, France
| | - Valérie Driss
- Clinical Investigation Centre, CHRU of Montpellier, Montpellier, France
| | | | | | - Serge Pinto
- Aix Marseille Univ., CNRS, LPL, Aix-en-Provence, France
| | - Simone Dalla Bella
- International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC, Canada
- Department of Psychology, University of Montreal, Montreal, QC, Canada
- Centre for Research on Brain, Language and Music (CRBLM), Montreal, QC, Canada
- University of Economics and Human Sciences in Warsaw, Warsaw, Poland
- Simone Dalla Bella,
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4
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Asano R, Boeckx C, Seifert U. Hierarchical control as a shared neurocognitive mechanism for language and music. Cognition 2021; 216:104847. [PMID: 34311153 DOI: 10.1016/j.cognition.2021.104847] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 05/14/2021] [Accepted: 07/11/2021] [Indexed: 12/16/2022]
Abstract
Although comparative research has made substantial progress in clarifying the relationship between language and music as neurocognitive systems from both a theoretical and empirical perspective, there is still no consensus about which mechanisms, if any, are shared and how they bring about different neurocognitive systems. In this paper, we tackle these two questions by focusing on hierarchical control as a neurocognitive mechanism underlying syntax in language and music. We put forward the Coordinated Hierarchical Control (CHC) hypothesis: linguistic and musical syntax rely on hierarchical control, but engage this shared mechanism differently depending on the current control demand. While linguistic syntax preferably engages the abstract rule-based control circuit, musical syntax rather employs the coordination of the abstract rule-based and the more concrete motor-based control circuits. We provide evidence for our hypothesis by reviewing neuroimaging as well as neuropsychological studies on linguistic and musical syntax. The CHC hypothesis makes a set of novel testable predictions to guide future work on the relationship between language and music.
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Affiliation(s)
- Rie Asano
- Systematic Musicology, Institute of Musicology, University of Cologne, Germany.
| | - Cedric Boeckx
- Section of General Linguistics, University of Barcelona, Spain; University of Barcelona Institute for Complex Systems (UBICS), Spain; Catalan Institute for Advanced Studies and Research (ICREA), Spain
| | - Uwe Seifert
- Systematic Musicology, Institute of Musicology, University of Cologne, Germany
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Terao Y, Honma M, Asahara Y, Tokushige SI, Furubayashi T, Miyazaki T, Inomata-Terada S, Uchibori A, Miyagawa S, Ichikawa Y, Chiba A, Ugawa Y, Suzuki M. Time Distortion in Parkinsonism. Front Neurosci 2021; 15:648814. [PMID: 33815049 PMCID: PMC8017233 DOI: 10.3389/fnins.2021.648814] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 02/24/2021] [Indexed: 11/13/2022] Open
Abstract
Although animal studies and studies on Parkinson’s disease (PD) suggest that dopamine deficiency slows the pace of the internal clock, which is corrected by dopaminergic medication, timing deficits in parkinsonism remain to be characterized with diverse findings. Here we studied patients with PD and progressive supranuclear palsy (PSP), 3–4 h after drug intake, and normal age-matched subjects. We contrasted perceptual (temporal bisection, duration comparison) and motor timing tasks (time production/reproduction) in supra- and sub-second time domains, and automatic versus cognitive/short-term memory–related tasks. Subjects were allowed to count during supra-second production and reproduction tasks. In the time production task, linearly correlating the produced time with the instructed time showed that the “subjective sense” of 1 s is slightly longer in PD and shorter in PSP than in normals. This was superposed on a prominent trend of underestimation of longer (supra-second) durations, common to all groups, suggesting that the pace of the internal clock changed from fast to slow as time went by. In the time reproduction task, PD and, more prominently, PSP patients over-reproduced shorter durations and under-reproduced longer durations at extremes of the time range studied, with intermediate durations reproduced veridically, with a shallower slope of linear correlation between the presented and produced time. In the duration comparison task, PD patients overestimated the second presented duration relative to the first with shorter but not longer standard durations. In the bisection task, PD and PSP patients estimated the bisection point (BP50) between the two supra-second but not sub-second standards to be longer than normal subjects. Thus, perceptual timing tasks showed changes in opposite directions to motor timing tasks: underestimating shorter durations and overestimating longer durations. In PD, correlation of the mini-mental state examination score with supra-second BP50 and the slope of linear correlation in the reproduction task suggested involvement of short-term memory in these tasks. Dopamine deficiency didn’t correlate significantly with timing performances, suggesting that the slowed clock hypothesis cannot explain the entire results. Timing performance in PD may be determined by complex interactions among time scales on the motor and sensory sides, and by their distortion in memory.
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Affiliation(s)
- Yasuo Terao
- Department of Medical Physiology, School of Medicine, Kyorin University, Tokyo, Japan
| | - Motoyasu Honma
- Department of Physiology, School of Medicine, Showa University, Tokyo, Japan
| | - Yuki Asahara
- Department of Neurology, The Jikei University Katsushika Medical Center, Tokyo, Japan
| | | | - Toshiaki Furubayashi
- Graduate School of Health and Environment Science, Tohoku Bunka Gakuen University, Sendai, Japan
| | - Tai Miyazaki
- Department of Neurology, Kyorin University Hospital, Tokyo, Japan
| | - Satomi Inomata-Terada
- Department of Medical Physiology, School of Medicine, Kyorin University, Tokyo, Japan
| | - Ayumi Uchibori
- Department of Neurology, Kyorin University Hospital, Tokyo, Japan
| | - Shinji Miyagawa
- Department of Neurology, The Jikei University Katsushika Medical Center, Tokyo, Japan
| | - Yaeko Ichikawa
- Department of Neurology, Kyorin University Hospital, Tokyo, Japan
| | - Atsuro Chiba
- Department of Neurology, Kyorin University Hospital, Tokyo, Japan
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Masahiko Suzuki
- Department of Neurology, The Jikei University Katsushika Medical Center, Tokyo, Japan
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6
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Janssen S, Heijs J, Bittner M, Droog E, Bloem BR, Van Wezel R, Heida T. Visual cues added to a virtual environment paradigm do not improve motor arrests in Parkinson's disease. J Neural Eng 2021; 18. [PMID: 33540389 DOI: 10.1088/1741-2552/abe356] [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: 03/27/2020] [Accepted: 02/04/2021] [Indexed: 11/12/2022]
Abstract
Objective. Elucidating how cueing alleviates freezing of gait (FOG) in Parkinson's disease (PD) would enable the development of more effective, personalized cueing strategies. Here, we aimed to validate a visual cueing virtual environment (VE) paradigm for future use in e.g. neuroimaging studies and behavioral studies on motor timing and scaling in PD patients with FOG.Approach. We included 20 PD patients with FOG and 16 age-matched healthy control subjects. Supine participants were confronted with a VE displaying either no cues, bars or staircases. They navigated forward using alternate suppression of foot pedals. Motor arrests (as proxy for FOG), and measures of motor timing and scaling were compared across the three VE conditions for both groups.Main results. VE cues (bars and staircases) did not reduce motor arrests in PD patients and healthy control subjects. The VE cues did reduce pedal amplitude in healthy control subjects, without effects on other motor parameters.Conclusion. We could not validate a visual cueing VE paradigm to study FOG. The VE cues possibly failed to convey the necessary spatial and temporal information to support motor timing and scaling. We discuss avenues for future research.
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Affiliation(s)
- S Janssen
- Biomedical Signals and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, EWI-BSS, Enschede 7500 VB, The Netherlands.,Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, Nijmegen, The Netherlands
| | - Jja Heijs
- Biomedical Signals and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, EWI-BSS, Enschede 7500 VB, The Netherlands
| | - M Bittner
- Biomedical Signals and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, EWI-BSS, Enschede 7500 VB, The Netherlands.,Current Address: VicarVision, Amsterdam, The Netherlands
| | - E Droog
- Biomedical Signals and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, EWI-BSS, Enschede 7500 VB, The Netherlands
| | - B R Bloem
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, Nijmegen, The Netherlands
| | - Rja Van Wezel
- Biomedical Signals and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, EWI-BSS, Enschede 7500 VB, The Netherlands.,Department of Biophysics, Donders Institute of Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - T Heida
- Biomedical Signals and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, EWI-BSS, Enschede 7500 VB, The Netherlands
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7
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People with Parkinson disease with and without freezing of gait respond similarly to external and self-generated cues. Gait Posture 2020; 82:161-166. [PMID: 32932076 PMCID: PMC7718283 DOI: 10.1016/j.gaitpost.2020.09.005] [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: 12/11/2019] [Revised: 08/27/2020] [Accepted: 09/01/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Gait deficits in Parkinson disease (PD), including freezing of gait (FOG), can be among the most debilitating symptoms. Rhythmic auditory cueing has been used to alleviate some gait symptoms. However, different cue types, such as externally-generated and self-generated cues, affect gait variability differently. The differential effects of these cue types on people with PD with FOG (PD + FOG), who often have higher gait variability, and those with PD without FOG (PD-FOG) is unknown. Given the relationship of gait variability to fall risk, this is an important area to address. RESEARCH QUESTION This study aims to 1) confirm the association between falls and gait variability measures in PD-FOG, PD + FOG and age-matched Controls; 2) investigate the effects of different cue types on gait variability in PD-FOG and PD + FOG; and 3) determine whether baseline gait characteristics are associated with response to cues. METHODS This cross-sectional study investigated PD-FOG (n = 24), PD + FOG (n = 20), and Controls (n = 24). Gait trials were collected during use of externally-generated and self-generated cues for all participants. Gait variability measures were the primary outcomes to assess the effects of rhythmic auditory cues. RESULTS Logistic regression models showed increased gait variability was associated with falls across groups. Repeated measures ANOVAs showed externally-generated cues increased gait variability, whereas self-generated cues did not, for all groups. Pearson's correlations showed participants with higher baseline gait variability had greater reduction in gait variability with rhythmic auditory cueing. SIGNIFICANCE Higher gait variability is associated with falls. This study demonstrates that PD + FOG are capable of using self-generated cues without increasing gait variability measures, thereby stabilizing gait. People with higher baseline gait variability are likely to experience the largest reductions in variability with the addition of external cues.
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8
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Puyjarinet F, Bégel V, Gény C, Driss V, Cuartero MC, Kotz SA, Pinto S, Dalla Bella S. Heightened orofacial, manual, and gait variability in Parkinson's disease results from a general rhythmic impairment. NPJ PARKINSONS DISEASE 2019; 5:19. [PMID: 31583269 PMCID: PMC6761142 DOI: 10.1038/s41531-019-0092-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 08/08/2019] [Indexed: 01/06/2023]
Abstract
Individuals with Parkinson’s disease (PD) experience rhythm disorders in a number of motor tasks, such as (i) oral diadochokinesis, (ii) finger tapping, and (iii) gait. These common motor deficits may be signs of “general dysrhythmia”, a central disorder spanning across effectors and tasks, and potentially sharing the same neural substrate. However, to date, little is known about the relationship between rhythm impairments across domains and effectors. To test this hypothesis, we assessed whether rhythmic disturbances in three different domains (i.e., orofacial, manual, and gait) can be related in PD. Moreover, we investigated whether rhythmic motor performance across these domains can be predicted by rhythm perception, a measure of central rhythmic processing not confounded with motor output. Twenty-two PD patients (mean age: 69.5 ± 5.44) participated in the study. They underwent neurological and neuropsychological assessments, and they performed three rhythmic motor tasks. For oral diadochokinesia, participants had to repeatedly produce a trisyllable pseudoword. For gait, they walked along a computerized walkway. For the manual task, patients had to repeatedly produce finger taps. The first two rhythmic motor tasks were unpaced, and the manual tapping task was performed both without a pacing stimulus and musically paced. Rhythm perception was also tested. We observed that rhythmic variability of motor performances (inter-syllable, inter-tap, and inter-stride time error) was related between the three functions. Moreover, rhythmic performance was predicted by rhythm perception abilities, as demonstrated with a logistic regression model. Hence, rhythm impairments in different motor domains are found to be related in PD and may be underpinned by a common impaired central rhythm mechanism, revealed by a deficit in rhythm perception. These results may provide a novel perspective on how interpret the effects of rhythm-based interventions in PD, within and across motor domains.
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Affiliation(s)
- Frédéric Puyjarinet
- 1EuroMov Laboratory, University of Montpellier, 700 Avenue du Pic Saint Loup, 34090 Montpellier, France
| | - Valentin Bégel
- Charles-de-Gaulle University, Lille 3, 42 Rue Paul Duez, 59 000 Lille, France
| | - Christian Gény
- 3Neurology Department, CHRU of Montpellier, 80 Avenue Augustin Fliche, 34000 Montpellier, France
| | - Valérie Driss
- 4Investigation Clinic Center, CHRU of Montpellier, 80 Avenue Augustin Fliche, 34000 Montpellier, France
| | | | - Sonja A Kotz
- 6Department of Neuropsychology and Psychopharmacology, University of Maastricht, Universiteitssingel, 6200 MD Maastricht, Netherlands
| | - Serge Pinto
- 5Aix Marseille Univ, CNRS, LPL, Aix-en-Provence, France
| | - Simone Dalla Bella
- 1EuroMov Laboratory, University of Montpellier, 700 Avenue du Pic Saint Loup, 34090 Montpellier, France.,7International Laboratory for Brain, Music and Sound Research (BRAMS), 90 Vincent-d'Indy Ave., Outremont, QC H2V 2S9 Canada.,8Department of Psychology, University of Montreal, 2900 Boulevard Edouard-Montpetit, Montréal, QCH3T 1J4 Montreal, Canada.,University of Economics and Human Sciences in Warsaw, Okopowa59, 01-043 Warsaw, Poland
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Luft F, Sharifi S, Mugge W, Schouten AC, Bour LJ, van Rootselaar AF, Veltink PH, Heida T. Deficits in tapping accuracy and variability in tremor patients. J Neuroeng Rehabil 2019; 16:54. [PMID: 31064378 PMCID: PMC6505201 DOI: 10.1186/s12984-019-0528-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 04/30/2019] [Indexed: 12/02/2022] Open
Abstract
Background The basal ganglia and cerebellum are brain structures involved in movement initiation, execution and termination. They are thought to be involved in the tremor generation and movement deficits in Parkinson’s disease (PD) and essential tremor (ET). Especially in PD, maintaining cyclic movement, such as walking or tapping can be significantly disturbed. Providing external cues improves timing of these movements in PD but its effect on ET has not yet been studied in depth. The aim of this study is to evaluate the usefulness of a bimanual tapping task as a tool during clinical decision making. Method Hand movements and tremor was recorded using accelerometers and EMG (m. extensor carpi ulnaris) from PD and ET patients and healthy controls during a bimanual tapping task as a way to distinguish PD from ET. All subjects performed the tapping task at two different frequencies, 2 Hz and 4 Hz, with and without the presence of auditory cues. Results No significant intra-group differences were found in the patient groups. Acceleration data revealed significantly less accurate tapping and more variable tapping in PD than in ET and healthy controls. ET subjects tapped less accurate and with a greater variability than healthy controls during the 4 Hz tapping task. Most interestingly the tapping accuracy improved in PD patients when kinetic tremor was recorded with EMG during the task. Conclusion Providing ET and PD patients with an external cue results in different tapping performances between patient groups and healthy controls. Furthermore, the findings suggest that kinetic tremor in PD enables patients to perform the task with a greater accuracy. So far this has not been shown in other studies.
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Affiliation(s)
- Frauke Luft
- Department of Biomedical Signals and Systems, University of Twente, Enschede, The Netherlands.
| | - Sarvi Sharifi
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Winfred Mugge
- Department of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
| | - Alfred C Schouten
- Department of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
| | - Lo J Bour
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Anne-Fleur van Rootselaar
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter H Veltink
- Department of Biomedical Signals and Systems, University of Twente, Enschede, The Netherlands
| | - Tijtske Heida
- Department of Biomedical Signals and Systems, University of Twente, Enschede, The Netherlands
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Pereira APS, Marinho V, Gupta D, Magalhães F, Ayres C, Teixeira S. Music Therapy and Dance as Gait Rehabilitation in Patients With Parkinson Disease: A Review of Evidence. J Geriatr Psychiatry Neurol 2019; 32:49-56. [PMID: 30558462 DOI: 10.1177/0891988718819858] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM This review aims to demonstrate the efficiency of music and dance for gait improvement and symptom alleviation in Parkinson disease. METHODOLOGY Studies that analyzed sound stimuli and dance in gait improvement in Parkinson disease were searched through PubMed, Scopus, Doaj, MEDLINE, and ScienceDirect databases from November 2017 to April 2018 and repeated in September 2018. RESULTS AND DISCUSSION Forty-five studies met the inclusion criteria to synthesize the findings on dance and music performance as a treatment for classical symptoms of Parkinson disease. Five reviews and 40 experimental papers have shown that rhythmic stimulation and dance provide the motor, cognitive, and quality of life benefits for participants with Parkinson disease. Thus, sound stimuli and dance offer satisfactory effects for gait, improving cognitive abilities such as motor control and adjustment and spatial memory. In addition, these new treatment modalities stimulate the elderly population to practice physical exercise, generating well-being and helping self-esteem. CONCLUSION Dance and music therapy interventions are noninvasive, simple treatment options, which promote gait and cognition.
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Affiliation(s)
- Ana Paula S Pereira
- 1 Department of Physical Therapy, Federal University of Piauí, Parnaíba, Brazil
| | - Victor Marinho
- 2 Neuro-innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil.,3 The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
| | - Daya Gupta
- 4 Department of Biology, Camden County College, Blackwood, NJ, USA
| | - Francisco Magalhães
- 2 Neuro-innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil.,3 The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
| | - Carla Ayres
- 2 Neuro-innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil
| | - Silmar Teixeira
- 1 Department of Physical Therapy, Federal University of Piauí, Parnaíba, Brazil.,2 Neuro-innovation Technology & Brain Mapping Laboratory, Federal University of Piauí, Parnaíba, Brazil.,3 The Northeast Biotechnology Network, Federal University of Piauí, Teresina, Brazil
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11
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Tokushige SI, Terao Y, Matsuda S, Furubayashi T, Sasaki T, Inomata-Terada S, Yugeta A, Hamada M, Tsuji S, Ugawa Y. Does the Clock Tick Slower or Faster in Parkinson's Disease? - Insights Gained From the Synchronized Tapping Task. Front Psychol 2018; 9:1178. [PMID: 30050482 PMCID: PMC6051396 DOI: 10.3389/fpsyg.2018.01178] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/18/2018] [Indexed: 11/13/2022] Open
Abstract
The rhythm of the internal clock is considered to be determined by the basal ganglia, with some studies suggesting slower internal clock in Parkinson's disease (PD). However, patients may also show motor hastening when they walk (festination) or are engaged in repetitive tapping, indicating faster ticking of the internal clock. Is the internal clock slower or faster in PD? The purpose of this study was to answer this question, i.e., how fast and slow a rhythm they can synchronize with, especially with reference to the limit of sensorimotor synchronization or temporal integration, representing the threshold of slower pace they can entrain into their motor actions, which is known to lie between 2 and 3 s in normal subjects but not yet studied in PD. We employed a synchronized tapping task that required subjects to tap the key in synchrony with repetitive tones at fixed interstimulus intervals (ISI) between 200 and 4800 ms. Twenty normal subjects and sixteen PD patients were enrolled, who were classified into early and advanced PD groups by UPDRS-III (early: 15 or less, advanced: more than 15). The ISI at which the response changes from synchronizing with the tones to lagging behind them was considered to be the limit of temporal integration. Early PD patients responded ahead of the tones (negative asynchrony), which became more apparent with repeated tapping. This suggested "faster" ticking clock even in the presence of the pacing tones. In normal subjects, the limit of temporal integration was around 2-3 s: below this, subjects could synchronize with the tones, while above it they had difficulty in synchronization. In early PD patients, the limit of temporal integration was significantly longer than in normal subjects, pointing to their enhanced ability to synchronize also with slower paces of tones, but advanced PD patients had significantly shortened limits, suggesting that advanced patients lost this ability. In conclusion, the limit of temporal integration is initially longer but gets shorter as the disease progresses. It can be explained by the hastening of the internal clock at the earlier stages of PD, followed by the loss of temporal integration.
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Affiliation(s)
- Shin-Ichi Tokushige
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuo Terao
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Cell Physiology, Kyorin University, Mitaka, Japan
| | - Shunichi Matsuda
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Toshiaki Furubayashi
- Department of Rehabilitation, Faculty of Medical Science and Welfare, Tohoku Bunka Gakuen University, Sendai, Japan
| | - Takuya Sasaki
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satomi Inomata-Terada
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akihiro Yugeta
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masashi Hamada
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shoji Tsuji
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshikazu Ugawa
- Department of Neurology, School of Medicine, Fukushima Medical University, Fukushima, Japan
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12
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Chen YH, Kuo TT, Kao JH, Huang EYK, Hsieh TH, Chou YC, Hoffer BJ. Exercise Ameliorates Motor Deficits and Improves Dopaminergic Functions in the Rat Hemi-Parkinson's Model. Sci Rep 2018; 8:3973. [PMID: 29507426 PMCID: PMC5838260 DOI: 10.1038/s41598-018-22462-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 02/23/2018] [Indexed: 01/08/2023] Open
Abstract
To determine the influences of exercise on motor deficits and dopaminergic transmission in a hemiparkinson animal model, we measured the effects of exercise on the ambulatory system by estimating spatio-temporal parameters during walking, striatal dopamine (DA) release and reuptake and synaptic plasticity in the corticostriatal pathway after unilateral 6-OHDA lesions. 6-OHDA lesioned hemiparkinsonian rats were exercised on a fixed speed treadmill for 30 minutes per day. Controls received the same lesion but no exercise. Animals were subsequently analyzed for behavior including gait analysis, rotarod performance and apomorphine induced rotation. Subsequently, in vitro striatal dopamine release was analyzed by using FSCV and activity-dependent plasticity in the corticostriatal pathway was measured in each group. Our data indicated that exercise could improve motor walking speed and increase the apomorphine-induced rotation threshold. Exercise also ameliorated spatiotemporal impairments in gait in PD animals. Exercise increased the parameters of synaptic plasticity formation in the corticostriatal pathway of PD animals as well as the dynamics of dopamine transmission in PD animals. Fixed speed treadmill training 30 minutes per day could ameliorate spatial-temporal gait impairment, improve walking speed, dopamine transmission as well as corticostriatal synaptic plasticity in the unilateral 6-OHDA lesioned rat model.
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Affiliation(s)
- Yuan-Hao Chen
- Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C..
| | - Tung-Tai Kuo
- Graduate Institute of Computer and Communication Engineering, National Taipei University of Technology, Taipei, Taiwan, R.O.C
| | - Jen-Hsin Kao
- Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Eagle Yi-Kung Huang
- Department of Pharmacology, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Tsung-Hsun Hsieh
- Department of Physical Therapy and Graduate Institute of Rehabilitation Science, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Ching Chou
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Barry J Hoffer
- Graduate Program on Neuroregeneration, Taipei Medical University, Taipei, Taiwan
- Department of Neurosurgery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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13
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Haas B, Clarke E, Elver L, Gowman E, Mortimer E, Byrd E. The reliability and validity of the L-test in people with Parkinson's disease. Physiotherapy 2017; 105:84-89. [PMID: 29395266 DOI: 10.1016/j.physio.2017.11.218] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 11/26/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the test-retest and concurrent validity of the L-test in a group of participants with mild to moderate Parkinson's disease. The L-test is an extended version of the Timed up and Go test, incorporating a longer walking distance and turns in two directions. DESIGN Cross-sectional. SETTING Community. PARTICIPANTS 16 participants (13 male), mean age 75 (SD 6.7) mean duration since diagnosis 7.1 years (±2.8). Disease severity was mild to moderate on the Hoehn and Yahr scale (mean 2.1; mode 2; range 1-3). 14 participants (12 male) completed the study. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES A Bland and Altman plot examined the agreement between first and second testing occasion of the L-test. Intra-class correlation coefficients (ICC) assessed the test-retest reliability. Concurrent validity was established by correlating the L-test with the Timed up and Go test (TUG). The Minimal Detectable Change with 95% confidence interval (MDC95) was calculated to determine the true change not due to chance. RESULTS The L-test showed excellent test-retest reliability on the Bland & Altman plot and the ICC. There was a high degree of agreement between measurements taken on days 1 and 2. The L-test correlated strongly with the Timed up and Go test on both measurement days with r=0.97 (p<0.001) and r=0.96 (p<0.001). The MDC95 was 5.31seconds. CONCLUSIONS The L-test is a reliable and valid outcome measurement for the assessment of walking ability in participants with mild to moderate Parkinson's disease.
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Affiliation(s)
- Bernhard Haas
- University of Plymouth, School of Health Professions, Peninsula Allied Health Centre, Derriford Rd, Plymouth PL6 8BH, United Kingdom.
| | - Elizabeth Clarke
- University of Plymouth, School of Health Professions, Peninsula Allied Health Centre, Derriford Rd, Plymouth PL6 8BH, United Kingdom
| | - Laura Elver
- University of Plymouth, School of Health Professions, Peninsula Allied Health Centre, Derriford Rd, Plymouth PL6 8BH, United Kingdom
| | - Emma Gowman
- University of Plymouth, School of Health Professions, Peninsula Allied Health Centre, Derriford Rd, Plymouth PL6 8BH, United Kingdom
| | - Emma Mortimer
- University of Plymouth, School of Health Professions, Peninsula Allied Health Centre, Derriford Rd, Plymouth PL6 8BH, United Kingdom
| | - Erin Byrd
- University of Plymouth, School of Health Professions, Peninsula Allied Health Centre, Derriford Rd, Plymouth PL6 8BH, United Kingdom
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14
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External input for gait in people with Parkinson’s disease with and without freezing of gait: One size does not fit all. J Neurol 2017; 264:1488-1496. [DOI: 10.1007/s00415-017-8552-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/15/2017] [Accepted: 06/19/2017] [Indexed: 10/19/2022]
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15
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Janssen S, Bolte B, Nonnekes J, Bittner M, Bloem BR, Heida T, Zhao Y, van Wezel RJA. Usability of Three-dimensional Augmented Visual Cues Delivered by Smart Glasses on (Freezing of) Gait in Parkinson's Disease. Front Neurol 2017; 8:279. [PMID: 28659862 PMCID: PMC5468397 DOI: 10.3389/fneur.2017.00279] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 05/29/2017] [Indexed: 12/16/2022] Open
Abstract
External cueing is a potentially effective strategy to reduce freezing of gait (FOG) in persons with Parkinson's disease (PD). Case reports suggest that three-dimensional (3D) cues might be more effective in reducing FOG than two-dimensional cues. We investigate the usability of 3D augmented reality visual cues delivered by smart glasses in comparison to conventional 3D transverse bars on the floor and auditory cueing via a metronome in reducing FOG and improving gait parameters. In laboratory experiments, 25 persons with PD and FOG performed walking tasks while wearing custom-made smart glasses under five conditions, at the end-of-dose. For two conditions, augmented visual cues (bars/staircase) were displayed via the smart glasses. The control conditions involved conventional 3D transverse bars on the floor, auditory cueing via a metronome, and no cueing. The number of FOG episodes and percentage of time spent on FOG were rated from video recordings. The stride length and its variability, cycle time and its variability, cadence, and speed were calculated from motion data collected with a motion capture suit equipped with 17 inertial measurement units. A total of 300 FOG episodes occurred in 19 out of 25 participants. There were no statistically significant differences in number of FOG episodes and percentage of time spent on FOG across the five conditions. The conventional bars increased stride length, cycle time, and stride length variability, while decreasing cadence and speed. No effects for the other conditions were found. Participants preferred the metronome most, and the augmented staircase least. They suggested to improve the comfort, esthetics, usability, field of view, and stability of the smart glasses on the head and to reduce their weight and size. In their current form, augmented visual cues delivered by smart glasses are not beneficial for persons with PD and FOG. This could be attributable to distraction, blockage of visual feedback, insufficient familiarization with the smart glasses, or display of the visual cues in the central rather than peripheral visual field. Future smart glasses are required to be more lightweight, comfortable, and user friendly to avoid distraction and blockage of sensory feedback, thus increasing usability.
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Affiliation(s)
- Sabine Janssen
- Biomedical Signal and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands.,Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Benjamin Bolte
- Biomedical Signal and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands
| | - Jorik Nonnekes
- Biomedical Signal and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands.,Department of Rehabilitation, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Marian Bittner
- Biomedical Signal and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands
| | - Bastiaan R Bloem
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Tjitske Heida
- Biomedical Signal and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands
| | - Yan Zhao
- Biomedical Signal and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands
| | - Richard J A van Wezel
- Biomedical Signal and Systems Group, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands.,Department of Biophysics, Donders Institute of Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
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16
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Te Woerd ES, Oostenveld R, de Lange FP, Praamstra P. Impaired auditory-to-motor entrainment in Parkinson's disease. J Neurophysiol 2017; 117:1853-1864. [PMID: 28179479 DOI: 10.1152/jn.00547.2016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 01/23/2017] [Accepted: 02/05/2017] [Indexed: 11/22/2022] Open
Abstract
Several electrophysiological studies suggest that Parkinson's disease (PD) patients have a reduced tendency to entrain to regular environmental patterns. Here we investigate whether this reduced entrainment concerns a generalized deficit or is confined to movement-related activity, leaving sensory entrainment intact. Magnetoencephalography was recorded during a rhythmic auditory target detection task in 14 PD patients and 14 control subjects. Participants were instructed to press a button when hearing a target tone amid an isochronous sequence of standard tones. The variable pitch of standard tones indicated the probability of the next tone to be a target. In addition, targets were occasionally omitted to evaluate entrainment uncontaminated by stimulus effects. Response times were not significantly different between groups and both groups benefited equally from the predictive value of standard tones. Analyses of oscillatory beta power over auditory cortices showed equal entrainment to the tones in both groups. By contrast, oscillatory beta power and event-related fields demonstrated a reduced engagement of motor cortical areas in PD patients, expressed in the modulation depth of beta power, in the response to omitted stimuli, and in an absent motor area P300 effect. Together, these results show equally strong entrainment of neural activity over sensory areas in controls and patients, but, in patients, a deficient translation of the adjustment to the task rhythm to motor circuits. We suggest that the reduced activation reflects not merely altered resonance to rhythmic external events, but a compromised recruitment of an endogenous response reflecting internal rhythm generation.NEW & NOTEWORTHY Previous studies suggest that motor cortical activity in PD patients has a reduced tendency to entrain to regular environmental patterns. This study demonstrates that the deficient entrainment in PD concerns the motor system only, by showing equally strong entrainment of neural activity over sensory areas in controls and patients but, in patients, a deficient translation of this adjustment to the task rhythm to motor circuits.
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Affiliation(s)
- Erik S Te Woerd
- Radboud University Medical Centre, Dept. of Neurology, Radboud University, Nijmegen, The Netherlands; and.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Robert Oostenveld
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Floris P de Lange
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Peter Praamstra
- Radboud University Medical Centre, Dept. of Neurology, Radboud University, Nijmegen, The Netherlands; and .,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
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17
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Hackney ME, Lee HL, Battisto J, Crosson B, McGregor KM. Context-Dependent Neural Activation: Internally and Externally Guided Rhythmic Lower Limb Movement in Individuals With and Without Neurodegenerative Disease. Front Neurol 2015; 6:251. [PMID: 26696952 PMCID: PMC4667008 DOI: 10.3389/fneur.2015.00251] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 11/16/2015] [Indexed: 12/24/2022] Open
Abstract
Parkinson’s disease is a neurodegenerative disorder that has received considerable attention in allopathic medicine over the past decades. However, it is clear that, to date, pharmacological and surgical interventions do not fully address symptoms of PD and patients’ quality of life. As both an alternative therapy and as an adjuvant to conventional approaches, several types of rhythmic movement (e.g., movement strategies, dance, tandem biking, and Tai Chi) have shown improvements to motor symptoms, lower limb control, and postural stability in people with PD (1–6). However, while these programs are increasing in number, still little is known about the neural mechanisms underlying motor improvements attained with such interventions. Studying limb motor control under task-specific contexts can help determine the mechanisms of rehabilitation effectiveness. Both internally guided (IG) and externally guided (EG) movement strategies have evidence to support their use in rehabilitative programs. However, there appears to be a degree of differentiation in the neural substrates involved in IG vs. EG designs. Because of the potential task-specific benefits of rhythmic training within a rehabilitative context, this report will consider the use of IG and EG movement strategies, and observations produced by functional magnetic resonance imaging and other imaging techniques. This review will present findings from lower limb imaging studies, under IG and EG conditions for populations with and without movement disorders. We will discuss how these studies might inform movement disorders rehabilitation (in the form of rhythmic, music-based movement training) and highlight research gaps. We believe better understanding of lower limb neural activity with respect to PD impairment during rhythmic IG and EG movement will facilitate the development of novel and effective therapeutic approaches to mobility limitations and postural instability.
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Affiliation(s)
- Madeleine E Hackney
- Atlanta VA Center for Visual and Neurocognitive Rehabilitation , Decatur, GA , USA ; Division of General Medicine and Geriatrics, Department of Medicine, Emory School of Medicine , Atlanta, GA , USA
| | - Ho Lim Lee
- Emory College of Arts and Sciences, Emory University , Atlanta, GA , USA
| | - Jessica Battisto
- Emory College of Arts and Sciences, Emory University , Atlanta, GA , USA
| | - Bruce Crosson
- Atlanta VA Center for Visual and Neurocognitive Rehabilitation , Decatur, GA , USA ; Department of Neurology, Emory School of Medicine , Atlanta, GA , USA
| | - Keith M McGregor
- Atlanta VA Center for Visual and Neurocognitive Rehabilitation , Decatur, GA , USA ; Department of Neurology, Emory School of Medicine , Atlanta, GA , USA
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18
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Ashoori A, Eagleman DM, Jankovic J. Effects of Auditory Rhythm and Music on Gait Disturbances in Parkinson's Disease. Front Neurol 2015; 6:234. [PMID: 26617566 PMCID: PMC4641247 DOI: 10.3389/fneur.2015.00234] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 10/22/2015] [Indexed: 12/05/2022] Open
Abstract
Gait abnormalities, such as shuffling steps, start hesitation, and freezing, are common and often incapacitating symptoms of Parkinson’s disease (PD) and other parkinsonian disorders. Pharmacological and surgical approaches have only limited efficacy in treating these gait disorders. Rhythmic auditory stimulation (RAS), such as playing marching music and dance therapy, has been shown to be a safe, inexpensive, and an effective method in improving gait in PD patients. However, RAS that adapts to patients’ movements may be more effective than rigid, fixed-tempo RAS used in most studies. In addition to auditory cueing, immersive virtual reality technologies that utilize interactive computer-generated systems through wearable devices are increasingly used for improving brain–body interaction and sensory–motor integration. Using multisensory cues, these therapies may be particularly suitable for the treatment of parkinsonian freezing and other gait disorders. In this review, we examine the affected neurological circuits underlying gait and temporal processing in PD patients and summarize the current studies demonstrating the effects of RAS on improving these gait deficits.
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Affiliation(s)
- Aidin Ashoori
- Columbia University College of Physicians & Surgeons , New York, NY , USA
| | - David M Eagleman
- Department of Neuroscience, Baylor College of Medicine , Houston, TX , USA
| | - Joseph Jankovic
- Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine , Houston, TX , USA
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