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Mildner S, Hotz I, Kübler F, Rausch L, Stampfer-Kountchev M, Panzl J, Brenneis C, Seebacher B. Effects of activity-oriented physiotherapy with and without eye movement training on dynamic balance, functional mobility, and eye movements in patients with Parkinson's disease: An assessor-blinded randomised controlled pilot trial. PLoS One 2024; 19:e0304788. [PMID: 38875243 PMCID: PMC11178185 DOI: 10.1371/journal.pone.0304788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 05/16/2024] [Indexed: 06/16/2024] Open
Abstract
OBJECTIVES To describe changes in balance, walking speed, functional mobility, and eye movements following an activity-oriented physiotherapy (AOPT) or its combination with eye movement training (AOPT-E) in patients with Parkinson's disease (PD). To explore the feasibility of a full-scale randomised controlled trial (RCT). METHODS Using an assessor-blinded pilot RCT, 25 patients with PD were allocated to either AOPT or AOPT-E. Supervised interventions were performed 30 minutes, 4x/weekly, for 4 weeks, alongside inpatient rehabilitation. Outcomes were assessed at baseline and post-intervention, including dynamic balance, walking speed, functional and dual-task mobility, ability to safely balance, health-related quality of life (HRQoL), depression, and eye movements (number/duration of fixations) using a mobile eye tracker. Freezing of gait (FOG), and falls-related self-efficacy were assessed at baseline, post-intervention, and 4-week follow-up. Effect sizes of 0.10 were considered weak, 0.30 moderate, and ≥0.50 strong. Feasibility was assessed using predefined criteria: recruitment, retention and adherence rates, adverse events, falls, and post-intervention acceptability using qualitative interviews. RESULTS Improvements were observed in dynamic balance (effect size r = 0.216-0.427), walking speed (r = 0.165), functional and dual-task mobility (r = 0.306-0.413), ability to safely balance (r = 0.247), HRQoL (r = 0.024-0.650), and depression (r = 0.403). Falls-related self-efficacy (r = 0.621) and FOG (r = 0.248) showed varied improvements, partly sustained at follow-up. Eye movement improvements were observed after AOPT-E only. Feasibility analysis revealed that recruitment was below target, with less than two patients recruited per month due to COVID-19 restrictions. Feasibility targets were met, with a retention rate of 96% (95% confidence interval [CI]: 77.68-99.79) and a 98.18% (95% CI: 96.12-99.20) adherence rate, exceeding the targets of 80% and 75%, respectively. One adverse event unrelated to the study intervention confirmed intervention safety, and interview data indicated high intervention acceptability. CONCLUSIONS AOPT-E and AOPT appeared to be effective in patients with PD. Feasibility of a larger RCT was confirmed and is needed to validate results.
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Affiliation(s)
- Sarah Mildner
- Department of Rehabilitation Science, Clinic for Rehabilitation Münster, Münster, Austria
| | - Isabella Hotz
- Department of Rehabilitation Science, Clinic for Rehabilitation Münster, Münster, Austria
| | - Franziska Kübler
- Department of Rehabilitation Science, Clinic for Rehabilitation Münster, Münster, Austria
| | - Linda Rausch
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | | | - Johanna Panzl
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria
| | - Christian Brenneis
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria
- Karl Landsteiner Institute for Interdisciplinary Rehabilitation Research, Münster, Austria
| | - Barbara Seebacher
- Department of Rehabilitation Science, Clinic for Rehabilitation Münster, Münster, Austria
- Karl Landsteiner Institute for Interdisciplinary Rehabilitation Research, Münster, Austria
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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Nerdal PT, Gandor F, Friedrich MU, Schappe L, Ebersbach G, Maetzler W. Vestibulo-Ocular Reflex Suppression: Clinical Relevance and Assessment in the Digital Age. Digit Biomark 2024; 8:52-58. [PMID: 38617128 PMCID: PMC11014718 DOI: 10.1159/000537842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/11/2024] [Indexed: 04/16/2024] Open
Abstract
Background Visual acuity and image stability are crucial for daily activities, particularly during head motion. The vestibulo-ocular reflex (VOR) and its suppression (VORS) support stable fixation of objects of interest. The VOR drives a reflexive eye movement to counter retinal slip of a stable target during head motion. In contrast, VORS inhibits this countermovement when the target stimulus is in motion. The VORS allows for object fixation when it aligns with the direction of the head's movement, or when an object within or outside the peripheral vision needs to be focused upon. Summary Deficits of the VORS have been linked to age-related diseases such as balance deficits associated with an increased fall risk. Therefore, the accurate assessment of the VORS is of particular clinical relevance. However, current clinical assessment methods for VORS are mainly qualitative and not sufficiently standardised. Recent advances in digital health technology, such as smartphone-based videooculography, offer a promising alternative for assessing VORS in a more accessible, efficient, and quantitative manner. Moreover, integrating mobile eye-tracking technology with virtual reality environments allows for the implementation of controlled VORS assessments with different visual inputs. These assessment approaches allow the extraction of novel parameters with potential pathomechanistic and clinical relevance. Key Messages We argue that researchers and clinicians can obtain a more nuanced understanding of this ocular stabilisation reflex and its associated pathologies by harnessing digital health technology for VORS assessment. Further research is warranted to explore the technologies' full potential and utility in clinical practice.
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Affiliation(s)
- Patrik Theodor Nerdal
- Department of Neurology, University Hospital Schleswig-Holstein and Kiel University, Kiel, Germany
| | - Florin Gandor
- Movement Disorders Hospital, Beelitz-Heilstätten, Beelitz, Germany
- Department of Neurology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Maximilian Uwe Friedrich
- Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Laurin Schappe
- Department of Neurology, Saarland University, Saarbrücken, Germany
| | - Georg Ebersbach
- Movement Disorders Hospital, Beelitz-Heilstätten, Beelitz, Germany
| | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein and Kiel University, Kiel, Germany
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Li H, Zhang X, Yang Y, Xie A. Abnormal eye movements in Parkinson's disease: From experimental study to clinical application. Parkinsonism Relat Disord 2023; 115:105791. [PMID: 37537120 DOI: 10.1016/j.parkreldis.2023.105791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 07/24/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative disease that integrates a series of motor symptoms and non-motor symptoms, making early recognition challenging. The exploration of biomarkers is urgently required. Abnormal eye movements in PD have been reported to appear in a variety of ways since eye tracking technology was developed, such as decreased saccade amplitude, extended saccade latency, and unique saccade patterns. Non-invasive, objective and simple eye tracking has the potential to provide effective biomarkers for the PD diagnosis, progression and cognitive impairment, as well as ideas for research into the occurrence and treatment strategy of motor symptoms. In this review, we introduced the fundamental eye movement patterns and typical eye movement paradigms (such as fixation, pro-saccade, anti-saccade, smooth tracking, and visual search), summarized the symptoms of various ocular motor abnormalities in PD, and discussed the research implications of oculomotor investigation to the pathogenesis of PD and related motor symptoms, as well as the clinical implications as biomarkers and its inspiration on treatment.
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Affiliation(s)
- Han Li
- Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China.
| | - Xue Zhang
- Department of Neurology, Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, Qingdao, China
| | - Yong Yang
- Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
| | - Anmu Xie
- Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China; The Cerebral Vascular Disease Institute, Qingdao University, Qingdao, China.
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Graham L, Armitage J, Vitorio R, Das J, Barry G, Godfrey A, McDonald C, Walker R, Mancini M, Morris R, Stuart S. Visual Exploration While Walking With and Without Visual Cues in Parkinson's Disease: Freezer Versus Non-Freezer. Neurorehabil Neural Repair 2023; 37:734-743. [PMID: 37772512 PMCID: PMC10666478 DOI: 10.1177/15459683231201149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
BACKGROUND Visual cues can improve gait in Parkinson's disease (PD), including those experiencing freezing of gait (FOG). However, responses are variable and underpinning mechanisms remain unclear. Visuo-cognitive processing (measured through visual exploration) has been implicated in cue response, but this has not been comprehensively examined. OBJECTIVE To examine visual exploration and gait with and without visual cues in PD who do and do not self-report FOG, and healthy controls (HC). METHODS 17 HC, 21 PD without FOG, and 22 PD with FOG walked with and without visual cues, under single and dual-task conditions. Visual exploration (ie, saccade frequency, duration, peak velocity, amplitude, and fixation duration) was measured via mobile eye-tracking and gait (ie, gait speed, stride length, foot strike angle, stride time, and stride time variability) with inertial sensors. RESULTS PD had impaired gait compared to HC, and dual-tasking made gait variables worse across groups (all P < .01). Visual cues improved stride length, foot strike angle, and stride time in all groups (P < .01). Visual cueing also increased saccade frequency, but reduced saccade peak velocity and amplitude in all groups (P < .01). Gait improvement related to changes in visual exploration with visual cues in PD but not HC, with relationships dependent on group (FOG vs non-FOG) and task (single vs dual). CONCLUSION Visual cues improved visual exploration and gait outcomes in HC and PD, with similar responses in freezers and non-freezers. Freezer and non-freezer specific associations between cue-related changes in visual exploration and gait indicate different underlying visuo-cognitive processing within these subgroups for cue response.
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Affiliation(s)
- Lisa Graham
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK
| | - Jordan Armitage
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK
| | - Rodrigo Vitorio
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK
- Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Julia Das
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK
- Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Gill Barry
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK
| | - Alan Godfrey
- Department of Computer and Information Science, Northumbria University, Newcastle, UK
| | | | - Richard Walker
- Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Martina Mancini
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
| | - Rosie Morris
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK
- Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Samuel Stuart
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK
- Northumbria Healthcare NHS Foundation Trust, North Shields, UK
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
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Reiner J, Franken L, Raveh E, Rosset I, Kreitman R, Ben-Ami E, Djaldetti R. Oculometric measures as a tool for assessment of clinical symptoms and severity of Parkinson's disease. J Neural Transm (Vienna) 2023; 130:1241-1248. [PMID: 37553460 PMCID: PMC10480268 DOI: 10.1007/s00702-023-02681-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 08/02/2023] [Indexed: 08/10/2023]
Abstract
Abnormalities of oculometric measures (OM) are widely described in people with Parkinson's disease (PD). However, knowledge of correlations between abnormal OM, disease severity and clinical assessment in PD patients is still lacking. To evaluate these correlations, PD patients (215 patients, mean age 69 ± 9.1 years, 79 females) with severe (H&Y > 3) and mild to moderate (H&Y ≤ 2) disease, and 215 age-matched healthy subjects were enrolled. All patients were evaluated using MDS-UPDRS and an oculometric test using computer vision and deep learning algorithms. Comparisons of OM between groups and correlations between OM and MDS-UPDRS scores were calculated. Saccadic latency (ms) was prolonged in patients with severe compared with mild to moderate disease (pro-saccades: 267 ± 69 vs. 238 ± 53, p = 0.0011; anti-saccades: 386 ± 119 vs. 352 ± 106, p = 0.0393) and in patients with mild to moderate disease versus healthy subjects (pro-saccades: 238 ± 53 vs. 220 ± 45, p = 0.0003; anti-saccades: 352 ± 106 vs. 289 ± 71, p < 0.0001). Error rate (%) was higher among patients with severe (64.06 ± 23.08) versus mild to moderate disease (49.84 ± 24.81, p = 0.0001), and versus healthy subjects (49.84 ± 24.81 vs. 28.31 ± 21.72, p = 0.00001). Response accuracy (%) was lower for patients with severe (75.66 ± 13.11) versus mild to moderate disease (79.66 ± 13.56, p = 0.0462), and versus healthy subjects (79.66 ± 13.56 vs. 90.27 ± 8.79, p < 0.0001). Pro- and anti-saccadic latency, error rate and accuracy were correlated with MDS-UPDRS scores (r = 0.32, 0.28, 0.36 and -0.30, respectively, p < 0.0001) and similar correlations were found with its axial subscore (R = 0.38, 0.29, 0.44, and -0.30, respectively, p < 0.0001). Several OM were different in patients under levodopa treatment. OM worsened as PD severity increases, and were correlated with MDS-UPDRS scores. Using OM can be implemented for PD patients' assessment as a tool to follow disease progression.
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Affiliation(s)
- Johnathan Reiner
- Department of Neurology, Rabin Medical Center, Movement Disorders Clinic, Beilinson Hospital, 4941492, Petach Tikva, Israel
- Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liron Franken
- Department of Neurology, Rabin Medical Center, Movement Disorders Clinic, Beilinson Hospital, 4941492, Petach Tikva, Israel
- Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | | | | | | - Ruth Djaldetti
- Department of Neurology, Rabin Medical Center, Movement Disorders Clinic, Beilinson Hospital, 4941492, Petach Tikva, Israel
- Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Waldthaler J, Sperlich A, König A, Stüssel C, Bremmer F, Timmermann L, Pedrosa D. High (130 Hz)- and mid (60 Hz)-frequency deep brain stimulation in the subthalamic nucleus differentially modulate response inhibition: A preliminary combined EEG and eye tracking study. Neuroimage Clin 2023; 37:103314. [PMID: 36630863 PMCID: PMC9841351 DOI: 10.1016/j.nicl.2023.103314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/23/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023]
Abstract
While deep brain stimulation (DBS) in the subthalamic nucleus (STN) improves motor functions in Parkinson's disease (PD), it may also increase impulsivity by interfering with the inhibition of reflexive responses. The aim of this study was to investigate if varying the pulse frequency of STN-DBS has a modulating effect on response inhibition and its neural correlates. For this purpose, 14 persons with PD repeated an antisaccade task in three stimulation settings (DBS off, high-frequency DBS (130 Hz), mid-frequency DBS (60 Hz)) in a randomized order, while eye movements and brain activity via high-density EEG were recorded. On a behavioral level, 130 Hz DBS stimulation had no effect on response inhibition measured as antisaccade error rate, while 60 Hz DBS induced a slight but significant reduction of directional errors compared with the DBS-off state and 130 Hz DBS. Further, stimulation with both frequencies decreased the onset latency of correct antisaccades, while increasing the latency of directional errors. Time-frequency domain analysis of the EEG data revealed that 60 Hz DBS was associated with an increase in preparatory theta power over a midfrontal region of interest compared with the off-DBS state which is generally regarded as a marker of increased cognitive control. While no significant differences in brain activity over mid- and lateral prefrontal regions of interest emerged between the 60 Hz and 130 Hz conditions, both stimulation frequencies were associated with a stronger midfrontal beta desynchronization during the mental preparation for correct antisaccades compared with DBS off-state which is discussed in the context of potentially enhanced proactive recruitment of the oculomotor network. Our preliminary findings suggest that mid-frequency STN-DBS may provide beneficial effects on response inhibition, while both 130 Hz- and 60 Hz STN-DBS may promote voluntary actions at the expense of slower reflexive responses.
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Affiliation(s)
- Josefine Waldthaler
- Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany; Department of Neurology, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain, and Behavior (CMBB), Philipps-University Marburg and Justus-Liebig-University, Giessen, Germany.
| | - Alexander Sperlich
- Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany; Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Aylin König
- Department of Neurophysics, Philipps-University Marburg, Marburg, Germany
| | - Charlotte Stüssel
- Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany; Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Frank Bremmer
- Center for Mind, Brain, and Behavior (CMBB), Philipps-University Marburg and Justus-Liebig-University, Giessen, Germany; Department of Neurophysics, Philipps-University Marburg, Marburg, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany; Department of Neurology, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain, and Behavior (CMBB), Philipps-University Marburg and Justus-Liebig-University, Giessen, Germany
| | - David Pedrosa
- Department of Neurology, University Hospital Giessen and Marburg, Marburg, Germany; Department of Neurology, Philipps-University Marburg, Marburg, Germany; Center for Mind, Brain, and Behavior (CMBB), Philipps-University Marburg and Justus-Liebig-University, Giessen, Germany
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Carelli L, Solca F, Tagini S, Torre S, Verde F, Ticozzi N, Ferrucci R, Pravettoni G, Aiello EN, Silani V, Poletti B. Gaze-Contingent Eye-Tracking Training in Brain Disorders: A Systematic Review. Brain Sci 2022; 12:brainsci12070931. [PMID: 35884737 PMCID: PMC9313363 DOI: 10.3390/brainsci12070931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 06/30/2022] [Accepted: 07/13/2022] [Indexed: 11/30/2022] Open
Abstract
Eye movement abnormalities in association with cognitive and emotional deficits have been described in neurological, neurodevelopmental, and psychiatric disorders. Eye-Tracking (ET) techniques could therefore enhance cognitive interventions by contingently providing feedback to patients. Since no consensus has been reached thus far on this approach, this study aimed at systematically reviewing the current evidence. This review was performed and reported according to PRISMA guidelines. Records were searched for in PubMed, Web of Science, and Scopus (1990–2021) through the following string: (‘Eye Tracking’ OR ‘Eye-Tracking’ OR ‘Oculomotor’) AND (‘Neuropsychol*’ OR ‘Cognitive’) AND (‘Rehabilitation’ OR ‘Training’ OR ‘Stimulation’). Study outcomes were thematically classified and qualitatively synthesized. A structured quality assessment was performed. A total of 24 articles were included, addressing neurodevelopmental (preterm infants and children with autism spectrum disorder, Rett syndrome, or ADHD; N = 14), psychiatric (mood and anxiety disorders or alcohol dependence; N = 7), and neurological conditions (stroke; N = 3). Overall, ET gaze-contingent training proved to be effective in improving cognitive and emotional alterations. However, population heterogeneity limits the generalizability of results. ET gaze-contingent protocols allow researchers to directly and dynamically train attentional functions; together with the recruitment of implicit, “bottom-up” strategies, these protocols are promising and possibly integrable with traditional cognitive approaches.
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Affiliation(s)
- Laura Carelli
- Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, I.R.C.C.S., 20149 Milan, Italy; (F.S.); (S.T.); (F.V.); (N.T.); (E.N.A.); (V.S.); (B.P.)
- Correspondence:
| | - Federica Solca
- Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, I.R.C.C.S., 20149 Milan, Italy; (F.S.); (S.T.); (F.V.); (N.T.); (E.N.A.); (V.S.); (B.P.)
| | - Sofia Tagini
- “Rita Levi Montalcini” Department of Neurosciences, University of Turin, 10126 Turin, Italy;
- Istituto Auxologico Italiano, I.R.C.C.S., U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, 28824 Piancavallo, Italy
| | - Silvia Torre
- Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, I.R.C.C.S., 20149 Milan, Italy; (F.S.); (S.T.); (F.V.); (N.T.); (E.N.A.); (V.S.); (B.P.)
| | - Federico Verde
- Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, I.R.C.C.S., 20149 Milan, Italy; (F.S.); (S.T.); (F.V.); (N.T.); (E.N.A.); (V.S.); (B.P.)
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, University of Milan, 20122 Milan, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, I.R.C.C.S., 20149 Milan, Italy; (F.S.); (S.T.); (F.V.); (N.T.); (E.N.A.); (V.S.); (B.P.)
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, University of Milan, 20122 Milan, Italy
| | - Roberta Ferrucci
- Department of Health Sciences, Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, International Medical School, University of Milan, 20122 Milan, Italy;
- Neurology Clinic III, ASST Santi Paolo e Carlo, 20142 Milan, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca’ Granda Foundation Maggiore Policlinico Hospital, 20162 Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy;
- European Institute of Oncology, IRCCS, 20141 Milan, Italy
| | - Edoardo Nicolò Aiello
- Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, I.R.C.C.S., 20149 Milan, Italy; (F.S.); (S.T.); (F.V.); (N.T.); (E.N.A.); (V.S.); (B.P.)
- PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, 20126 Monza, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, I.R.C.C.S., 20149 Milan, Italy; (F.S.); (S.T.); (F.V.); (N.T.); (E.N.A.); (V.S.); (B.P.)
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, University of Milan, 20122 Milan, Italy
- Department of Health Sciences, Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, International Medical School, University of Milan, 20122 Milan, Italy;
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, I.R.C.C.S., 20149 Milan, Italy; (F.S.); (S.T.); (F.V.); (N.T.); (E.N.A.); (V.S.); (B.P.)
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Liu X, Huang H, Snutch TP, Cao P, Wang L, Wang F. The Superior Colliculus: Cell Types, Connectivity, and Behavior. Neurosci Bull 2022; 38:1519-1540. [PMID: 35484472 DOI: 10.1007/s12264-022-00858-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/16/2022] [Indexed: 10/18/2022] Open
Abstract
The superior colliculus (SC), one of the most well-characterized midbrain sensorimotor structures where visual, auditory, and somatosensory information are integrated to initiate motor commands, is highly conserved across vertebrate evolution. Moreover, cell-type-specific SC neurons integrate afferent signals within local networks to generate defined output related to innate and cognitive behaviors. This review focuses on the recent progress in understanding of phenotypic diversity amongst SC neurons and their intrinsic circuits and long-projection targets. We further describe relevant neural circuits and specific cell types in relation to behavioral outputs and cognitive functions. The systematic delineation of SC organization, cell types, and neural connections is further put into context across species as these depend upon laminar architecture. Moreover, we focus on SC neural circuitry involving saccadic eye movement, and cognitive and innate behaviors. Overall, the review provides insight into SC functioning and represents a basis for further understanding of the pathology associated with SC dysfunction.
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Affiliation(s)
- Xue Liu
- Shenzhen Key Lab of Neuropsychiatric Modulation, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, the Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China.,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Hongren Huang
- Shenzhen Key Lab of Neuropsychiatric Modulation, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, the Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China.,University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Terrance P Snutch
- Michael Smith Laboratories and Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, V6T 1Z4, Canada
| | - Peng Cao
- National Institute of Biological Sciences, Beijing, 100049, China
| | - Liping Wang
- Shenzhen Key Lab of Neuropsychiatric Modulation, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, the Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China.
| | - Feng Wang
- Shenzhen Key Lab of Neuropsychiatric Modulation, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, the Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China.
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9
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Waldthaler J, Stock L, Student J, Sommerkorn J, Dowiasch S, Timmermann L. Antisaccades in Parkinson's Disease: A Meta-Analysis. Neuropsychol Rev 2021; 31:628-642. [PMID: 33742354 PMCID: PMC8592977 DOI: 10.1007/s11065-021-09489-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 02/18/2021] [Indexed: 11/29/2022]
Abstract
The usefulness of eye-tracking tasks as potential biomarkers for motor or cognitive disease burden in Parkinson's disease (PD) has been subject of debate for many years. Several studies suggest that the performance in the antisaccade task may be altered in patients with PD and associated with motor disease severity or executive dysfunction. In this meta-analysis, random effects models were used to synthesize the existing evidence on antisaccade error rates and latency in PD. Furthermore, meta-regressions were performed to assess the role of motor and cognitive disease severity, dopaminergic medication and methodological factors. Additionally, the impact of acute levodopa administration and activation of deep brain stimulation was evaluated in two separate sub-analyses.This meta-analysis confirms that antisaccade latency and error rate are significantly increased in PD. Disease duration, Unified Parkinson's disease rating scale score and Hoehn and Yahr stage mediate the effect of PD on antisaccade latency with higher motor burden being associated with increased antisaccade latency.Acute administration of levodopa had no significant effects on antisaccade performance in a small number of eligible studies. Deep brain stimulation in the subthalamic nucleus, on the other hand, may alter the speed accuracy trade-off supporting an increase of impulsivity following deep brain stimulation in PD.According to the results of the meta-analysis, antisaccade latency may provide a potential marker for disease severity and progression in PD which needs further confirmation in longitudinal studies.
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Affiliation(s)
- Josefine Waldthaler
- Department of Neurology, University Hospital Marburg, 35033, Marburg, Germany.
- CMBB - Center for Mind, Brain and Behavior, Universities Gießen and Marburg, Marburg, Germany.
| | - Lena Stock
- Department of Neurology, University Hospital Marburg, 35033, Marburg, Germany
| | - Justus Student
- Department of Neurology, University Hospital Marburg, 35033, Marburg, Germany
| | - Johanna Sommerkorn
- Department of Neurology, University Hospital Marburg, 35033, Marburg, Germany
| | - Stefan Dowiasch
- CMBB - Center for Mind, Brain and Behavior, Universities Gießen and Marburg, Marburg, Germany
- Department of Neurophysics, University of Marburg, Marburg, Germany
- Thomas RECORDING GmbH, Giessen, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital Marburg, 35033, Marburg, Germany
- CMBB - Center for Mind, Brain and Behavior, Universities Gießen and Marburg, Marburg, Germany
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10
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Saçmacı H, Erkoç MF, Aktürk T. Measurement of the facial nerve thickness and its correlation with freezing phenomenon and hypomimia in Parkinson's disease. Clin Neurol Neurosurg 2021; 210:106960. [PMID: 34571338 DOI: 10.1016/j.clineuro.2021.106960] [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: 02/14/2021] [Revised: 05/25/2021] [Accepted: 09/15/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Hypomimia is one of the diagnostic features in Parkinson's disease, and freezing blocks may also occur with the degenerative process. We investigated that the thickness of the cranial facial nerve that innervates facial expressions, and the relationship between bradymimia and freezing phenomena in these patients. METHODS We included 70 patients and healthy participants in this cross-sectional study. Clinical characteristics, modified Hoehn and Yahr (mHY) stages, Unified Parkinson's Disease Rating Scale (UPDRS) scores and Freezing of Gait Questionnaire (FOG-Q) scores of Parkinson's patients were recorded. FOG-Q was scored between 1 and 4 points. The thickness of the facial nerve and its neighborhoods of numerically equal groups were measured radiologically in the internal acoustic channel (IAC) with magnetic resonance imaging of temporal lobe. Right and left facial nerve thicknesses were compared. RESULTS The right facial nerve thicknesses of the patient and control groups were measured as 0.97 ± 0.12 mm and 1.20 ± 0.10 mm at the proximal level and 0.71 (0.69-0.81) mm and 1.21 (1.13-1.24) mm at the distal level, respectively (P < 0.001). Notably, the facial nerve was more atrophied on the right than on the left (P < 0.001). Facial nerve to IAC ratio (%) was significantly lower and cerebrospinal fluid thickness distance (%) measurement was significantly higher (P < 0.001). Also, the FOG-Q and facial nerve to IAC ratio were negatively correlated (P = 0.049, rho = -0.335). CONCLUSIONS Our study provides new information about the facial nerve and its neighborhoods and clinical relationships in individuals with PD. In studies investigating hypomimia and FOG in Parkinson's, neuroimaging of the facial nerve can also be used. These results need to be proven with more comprehensive studies.
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Affiliation(s)
| | | | - Tülin Aktürk
- Bozok University Medical School, Yozgat, Turkey.
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11
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Likitgorn T, Yan Y, Liao YJ. Freezing of saccades in dopa-responsive parkinsonian syndrome. Am J Ophthalmol Case Rep 2021; 23:101124. [PMID: 34169178 PMCID: PMC8208961 DOI: 10.1016/j.ajoc.2021.101124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 04/19/2021] [Accepted: 05/17/2021] [Indexed: 11/01/2022] Open
Abstract
Purpose Ocular motor abnormalities such as abnormal saccades are common in idiopathic Parkinson's disease (PD) and atypical parkinsonian syndrome, such as progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). In this study, we describe a case of patient with PD and show a video illustrating severe delay of reflexive saccades. Observations A 68-year-old Caucasian woman with diagnosis of PD presented for evaluation of diplopia. Neuro-ophthalmic examination revealed good visual acuity in both eyes and normal optic nerves but prominent ocular motor abnormalities, including hypometric saccades, impaired smooth pursuit, and convergence insufficiency causing diplopia at near. Despite treatment with carbidopa-levodopa three times per day, she exhibited episodic, severe delay of reflexive saccades. During these episodes, the patient appeared frozen and unable to initiate reflexive saccades for 20 s or longer. This freezing of reflexive saccades was variable and occurred suddenly during exam but could be interrupted by smooth pursuit. There was no gait freezing, eyelid apraxia, or prominent exacerbation of other motor symptoms. Freezing of saccades dramatically resolved after increasing dosage of carbidopa-levodopa. Conclusions and Importance We describe a patient with dopa-responsive parkinsonian syndrome with intermittent difficulty initiating reflexive saccades mimicking ocular motor apraxia. Resolution of saccadic freezing with higher carbidopa-levodopa is consistent with ocular motor impairment as a result of degeneration and dysfunction of the dopaminergic pathways in supranuclear ocular motor control.
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Affiliation(s)
- Techawit Likitgorn
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA.,Ophthalmology Center, Thonburi Hospital, Bangkok, Thailand
| | - Yan Yan
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA.,Department of Ophthalmology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yaping Joyce Liao
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA.,Department of Neurology, Stanford University School of Medicine, Stanford, CA, USA
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12
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Gallea C, Wicki B, Ewenczyk C, Rivaud-Péchoux S, Yahia-Cherif L, Pouget P, Vidailhet M, Hainque E. Antisaccade, a predictive marker for freezing of gait in Parkinson's disease and gait/gaze network connectivity. Brain 2021; 144:504-514. [PMID: 33279957 DOI: 10.1093/brain/awaa407] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 09/17/2020] [Accepted: 09/20/2020] [Indexed: 11/14/2022] Open
Abstract
Freezing of gait is a challenging sign of Parkinson's disease associated with disease severity and progression and involving the mesencephalic locomotor region. No predictive factor of freezing has been reported so far. The primary objective of this study was to identify predictors of freezing occurrence at 5 years. In addition, we tested whether functional connectivity of the mesencephalic locomotor region could explain the oculomotor factors at baseline that were predictive of freezing onset. We performed a prospective study investigating markers (parkinsonian signs, cognitive status and oculomotor recordings, with a particular focus on the antisaccade latencies) of disease progression at baseline and at 5 years. We identified two groups of patients defined by the onset of freezing at 5 years of follow-up; the 'Freezer' group was defined by the onset of freezing in the ON medication condition during follow-up (n = 17), while the 'non-Freezer' group did not (n = 8). Whole brain resting-state functional MRI was recorded at baseline to determine how antisaccade latencies were associated with connectivity of the mesencephalic locomotor region networks in patients compared to 25 age-matched healthy volunteers. Results showed that, at baseline and compared to the non-Freezer group, the Freezer group had equivalent motor or cognitive signs, but increased antisaccade latencies (P = 0.008). The 5-year course of freezing of gait was correlated with worsening antisaccade latencies (P = 0.0007). Baseline antisaccade latencies was also predictive of the freezing onset (χ2 = 0.008). Resting state connectivity of mesencephalic locomotor region networks correlated with (i) antisaccade latency differently in patients and healthy volunteers at baseline; and (ii) the further increase of antisaccade latency at 5 years. We concluded that antisaccade latency is a predictive marker of the 5-year onset of freezing of gait. Our study suggests that functional networks associated with gait and gaze control are concurrently altered during the course of the disease.
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Affiliation(s)
- Cécile Gallea
- Sorbonne Université, UMR S 1127, Inserm U 1127, and CNRS UMR 7225, and Institut du Cerveau et de la Moelle épinière, F-75013, Paris, France
| | - Benoit Wicki
- Service de Neurologie, Hôpital du Valais, Sion, Switzerland
| | - Claire Ewenczyk
- Department of Genetics, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
| | - Sophie Rivaud-Péchoux
- Sorbonne Université, UMR S 1127, Inserm U 1127, and CNRS UMR 7225, and Institut du Cerveau et de la Moelle épinière, F-75013, Paris, France
| | - Lydia Yahia-Cherif
- Sorbonne Université, UMR S 1127, Inserm U 1127, and CNRS UMR 7225, and Institut du Cerveau et de la Moelle épinière, F-75013, Paris, France
| | - Pierre Pouget
- Sorbonne Université, UMR S 1127, Inserm U 1127, and CNRS UMR 7225, and Institut du Cerveau et de la Moelle épinière, F-75013, Paris, France
| | - Marie Vidailhet
- Sorbonne Université, UMR S 1127, Inserm U 1127, and CNRS UMR 7225, and Institut du Cerveau et de la Moelle épinière, F-75013, Paris, France.,Department of Neurology, Hôpital Pitié-Salpêtrière , AP-HP, Paris, France
| | - Elodie Hainque
- Sorbonne Université, UMR S 1127, Inserm U 1127, and CNRS UMR 7225, and Institut du Cerveau et de la Moelle épinière, F-75013, Paris, France.,Department of Neurology, Hôpital Pitié-Salpêtrière , AP-HP, Paris, France
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13
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Marquez JS, Hasan SMS, Siddiquee MR, Luca CC, Mishra VR, Mari Z, Bai O. Neural Correlates of Freezing of Gait in Parkinson's Disease: An Electrophysiology Mini-Review. Front Neurol 2020; 11:571086. [PMID: 33240199 PMCID: PMC7683766 DOI: 10.3389/fneur.2020.571086] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/23/2020] [Indexed: 12/13/2022] Open
Abstract
Freezing of gait (FoG) is a disabling symptom characterized as a brief inability to step or by short steps, which occurs when initiating gait or while turning, affecting over half the population with advanced Parkinson's disease (PD). Several non-competing hypotheses have been proposed to explain the pathophysiology and mechanism behind FoG. Yet, due to the complexity of FoG and the lack of a complete understanding of its mechanism, no clear consensus has been reached on the best treatment options. Moreover, most studies that aim to explore neural biomarkers of FoG have been limited to semi-static or imagined paradigms. One of the biggest unmet needs in the field is the identification of reliable biomarkers that can be construed from real walking scenarios to guide better treatments and validate medical and therapeutic interventions. Advances in neural electrophysiology exploration, including EEG and DBS, will allow for pathophysiology research on more real-to-life scenarios for better FoG biomarker identification and validation. The major aim of this review is to highlight the most up-to-date studies that explain the mechanisms underlying FoG through electrophysiology explorations. The latest methodological approaches used in the neurophysiological study of FoG are summarized, and potential future research directions are discussed.
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Affiliation(s)
- J. Sebastian Marquez
- Department of Electrical and Computer Engineering, Florida International University, Miami, FL, United States
| | - S. M. Shafiul Hasan
- Department of Electrical and Computer Engineering, Florida International University, Miami, FL, United States
| | - Masudur R. Siddiquee
- Department of Electrical and Computer Engineering, Florida International University, Miami, FL, United States
| | - Corneliu C. Luca
- Department of Neurology, University of Miami Hospital, Miami, FL, United States
| | - Virendra R. Mishra
- Lou Ruvo Center for Brain Health, Cleveland Clinic, Las Vegas, NV, United States
| | - Zoltan Mari
- Lou Ruvo Center for Brain Health, Cleveland Clinic, Las Vegas, NV, United States
| | - Ou Bai
- Department of Electrical and Computer Engineering, Florida International University, Miami, FL, United States
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14
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Wu L, Wang Q, Zhao L, Jiang CY, Xu Q, Wu SC, Dong YR, He Q, Chen W, Liu JR. Clinical and Oculomotor Correlates With Freezing of Gait in a Chinese Cohort of Parkinson's Disease Patients. Front Aging Neurosci 2020; 12:237. [PMID: 32903684 PMCID: PMC7438737 DOI: 10.3389/fnagi.2020.00237] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 07/08/2020] [Indexed: 12/13/2022] Open
Abstract
Accumulating evidence suggests that freezing of gait (FOG) is a unique gait disturbance in Parkinson’s disease (PD), and its pathophysiology is not fully elucidated. The present study aims to investigate the clinical and oculomotor associations with FOG in Chinese PD patients. From Jan 2017 to Dec 2019, a total of 210 PD patients were consecutively registered for FOG evaluation based on item-3 of the Freezing of Gait Questionnaire (FOGQ). We explored the demographic, motor, and non-motor symptom differences in FOG positive (PD+FOG, n = 45) vs. negative (PD-FOG, n = 165) group. In addition, 40 PD patients and 37 healthy controls (HC) also underwent oculomotor test via videonystagmography (VNG). Visually guided saccade (VGS) latency, saccade accuracy and gain in smooth pursuit eye movement (SPEM) at three frequencies of horizontal axis were compared among PD+FOG (n = 20), PD-FOG (n = 20), and HC (n = 37). Compared with PD-FOG, PD+FOG had longer disease duration, more severe motor symptoms, lower cognitive scores, more severe depressive and autonomic impairments, as well as higher daily levodopa equivalent dosage. FOG occurred more frequently in patients with wearing-off. VNG subgroup analysis demonstrated that PD+FOG had prolonged saccade latency and decreased saccade accuracy relative to PD-FOG or HC. SPEM gain at 0.1 and 0.2 Hz was also decreased in PD+FOG compared with HC. Furthermore, prolonged saccade latency was correlated with higher FOGQ scores in PD patients. Our results verify that PD with FOG patients suffer from more severe motor and non-motor symptoms, indicating more extensive neurodegeneration. Prolonged saccade latency could be a practical oculomotor parameter both for identification and progression of FOG in PD.
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Affiliation(s)
- Li Wu
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qin Wang
- Department of Neurology, Zhongshan Hospital Fudan University, Shanghai, China
| | - Lei Zhao
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chun-Yan Jiang
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Xu
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Si-Cheng Wu
- Biostatistics Office of Clinical Research Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - You-Rong Dong
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing He
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Chen
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian-Ren Liu
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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15
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Ehgoetz Martens KA, Peterson DS, Almeida QJ, Lewis SJG, Hausdorff JM, Nieuwboer A. Behavioural manifestations and associated non-motor features of freezing of gait: A narrative review and theoretical framework. Neurosci Biobehav Rev 2020; 116:350-364. [PMID: 32603716 DOI: 10.1016/j.neubiorev.2020.06.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 12/30/2022]
Abstract
Over the past decade, non-motor related symptoms and provocative contexts have offered unique opportunities to gain insight into the potential mechanisms that may underpin freezing of gait (FOG) in Parkinson's disease (PD). While this large body of work has informed several theoretical models, to date, few are capable of explaining behavioural findings across multiple domains (i.e. cognitive, sensory-perceptual and affective) and in different behavorial contexts. As such, the exact nature of these interrelationships and their neural basis remain quite enigmatic. Here, the non-motor, behavioural evidence for cognitive, sensory-perceptual and affective contributors to FOG are reviewed and synthesized by systematically examining (i) studies that manipulated contextual environments that provoke freezing of gait, (ii) studies that uncovered factors that have been proposed to contribute to freezing, and (iii) studies that longitudinally tracked factors that predict the future development of freezing of gait. After consolidating the evidence, we offer a novel perspective for integrating these multi-faceted behavioural patterns and identify key challenges that warrant consideration in future work.
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Affiliation(s)
| | - Daniel S Peterson
- College of Health Solutions, Arizona State University, Arizona, USA; Phoenix Veterans Affairs Medical Centre, Arizona, USA
| | - Quincy J Almeida
- Movement Disorders Research & Rehabilitation Centre, Laurier University, Waterloo, ON, Canada
| | - Simon J G Lewis
- ForeFront Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Camperdown, New South Wales, Australia
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Dept of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Alice Nieuwboer
- Department of Rehabilitation Science, University of Leuven, Leuven, Belgium
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16
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Mahlknecht P, Kaski D, Georgiev D, Foltynie T, Limousin P. Reply: Pathophysiology of gait disorders induced by bilateral globus pallidus interna stimulation in dystonia. Brain 2019; 143:e4. [DOI: 10.1093/brain/awz357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Philipp Mahlknecht
- Department of Clinical and Motor Neuroscience, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Diego Kaski
- Department of Clinical and Motor Neuroscience, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Dejan Georgiev
- Department of Clinical and Motor Neuroscience, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
- Department of Neurology, Medical University Ljubljana, Ljubljana, Slovenia
| | - Thomas Foltynie
- Department of Clinical and Motor Neuroscience, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Patricia Limousin
- Department of Clinical and Motor Neuroscience, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
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17
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Camacho PB, Carbonari R, Shen S, Zadikoff C, Kramer AF, López-Ortiz C. Voluntary Saccade Training Protocol in Persons With Parkinson's Disease and Healthy Adults. Front Aging Neurosci 2019; 11:77. [PMID: 31024292 PMCID: PMC6459894 DOI: 10.3389/fnagi.2019.00077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 03/19/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Voluntary saccade function gradually decreases during both the progression of Parkinson's disease (PD) and neurologically healthy adult aging. Voluntary saccades display decreased length and increased saccade latency, duration, and the number of compensatory saccades in aging and PD. Saccades serve as the key eye movement for maintaining salient features of the visual environment on the high visual acuity fovea of the retina. Abnormal saccade behavior has been associated with freezing of gait in PD. We have not identified any studies that have investigated improvement in voluntary saccade function using voluntary saccade training. Objective: We report an experimental protocol that tests a training paradigm following the principle of specificity to improve voluntary saccade velocity and amplitude, while decreasing latency and the number of compensatory saccades. Methods: Persons with PD (n = 22) and persons with no known neurological disorders (n = 22) between the ages of 40 and 65 years will be recruited. In a randomized-block study design, all participants will perform voluntary saccades to targets in eight cardinal and intercardinal directions. In each of the eight sessions during the four-week intervention period, participants will train at three target amplitudes. Participants will perform 40 trials for each amplitude block, consisting of five randomly presented repetitions for each direction. Voluntary and reflexive saccades will be recorded pre- and post-intervention, along with clinical mobility assessment using the Movement Disorder Society Unified Parkinson's Disease Rating Scale. Mobility scores, the amplitude, latency, and duration of the first saccade, and the number of saccades to reach the fixation target will be analyzed using an ANOVA of mixed effects. Discussion: This protocol holds promise as a potential method to improve voluntary saccade function in persons with PD. Should persons with PD not improve on any outcome following the intervention, this lack of response may support the use of saccade assessment as a response biomarker for the diagnosis of PD. Trial Registration: This protocol was retrospectively registered at ISRCTN (ISRCTN.com) since July 25, 2018. The first participant was recruited March 12, 2016. The protocol identifier is 17784042. Descriptive Title: A two-arm, pre/post-protocol to compare the effects of a four-week voluntary saccade training intervention in persons with Parkinson's disease and healthy adults aged forty years or older.
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Affiliation(s)
- Paul B Camacho
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Ronald Carbonari
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Sa Shen
- Center on Health, Aging and Disability, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Cindy Zadikoff
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Arthur F Kramer
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States.,Center for Cognitive and Brain Health, Department of Psychology, Northeastern University, Boston, MA, United States
| | - Citlali López-Ortiz
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States.,Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States.,Center on Health, Aging and Disability, University of Illinois at Urbana-Champaign, Champaign, IL, United States.,Joffrey Ballet Academy, The Official School of the Joffrey Ballet, Chicago, IL, United States
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18
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Srivastava A, Ahmad OF, Pacia CP, Hallett M, Lungu C. The Relationship between Saccades and Locomotion. J Mov Disord 2018; 11:93-106. [PMID: 30086615 PMCID: PMC6182301 DOI: 10.14802/jmd.18018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 04/26/2018] [Indexed: 12/11/2022] Open
Abstract
Human locomotion involves a complex interplay among multiple brain regions and depends on constant feedback from the visual system. We summarize here the current understanding of the relationship among fixations, saccades, and gait as observed in studies sampling eye movements during locomotion, through a review of the literature and a synthesis of the relevant knowledge on the topic. A significant overlap in locomotor and saccadic neural circuitry exists that may support this relationship. Several animal studies have identified potential integration nodes between these overlapping circuitries. Behavioral studies that explored the relationship of saccadic and gait-related impairments in normal conditions and in various disease states are also discussed. Eye movements and locomotion share many underlying neural circuits, and further studies can leverage this interplay for diagnostic and therapeutic purposes.
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Affiliation(s)
- Anshul Srivastava
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Omar F Ahmad
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Christopher Pham Pacia
- Department of Biomedical Engineering, Washington University in St. Louis, Saint Louis, MO, USA
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Codrin Lungu
- Division of Clinical Research, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
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19
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Shaikh AG, Antoniades C, Fitzgerald J, Ghasia FF. Effects of Deep Brain Stimulation on Eye Movements and Vestibular Function. Front Neurol 2018; 9:444. [PMID: 29946295 PMCID: PMC6005881 DOI: 10.3389/fneur.2018.00444] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 05/25/2018] [Indexed: 12/20/2022] Open
Abstract
Discovery of inter-latching circuits in the basal ganglia and invention of deep brain stimulation (DBS) for their modulation is a breakthrough in basic and clinical neuroscience. The DBS not only changes the quality of life of hundreds of thousands of people with intractable movement disorders, but it also offers a unique opportunity to understand how the basal ganglia interacts with other neural structures. An attractive yet less explored area is the study of DBS on eye movements and vestibular function. From the clinical perspective such studies provide valuable guidance in efficient programming of stimulation profile leading to optimal motor outcome. From the scientific standpoint such studies offer the ability to assess the outcomes of basal ganglia stimulation on eye movement behavior in cognitive as well as in motor domains. Understanding the influence of DBS on ocular motor function also leads to analogies to interpret its effects on complex appendicular and axial motor function. This review focuses on the influence of globus pallidus, subthalamic nucleus, and thalamus DBS on ocular motor and vestibular functions. The anatomy and physiology of basal ganglia, pertinent to the principles of DBS and ocular motility, is discussed. Interpretation of the effects of electrical stimulation of the basal ganglia in Parkinson's disease requires understanding of baseline ocular motor function in the diseased brain. Therefore we have also discussed the baseline ocular motor deficits in these patients and how the DBS changes such functions.
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Affiliation(s)
- Aasef G Shaikh
- Department of Neurology, University Hospitals, Case Western Reserve University, Cleveland, OH, United States.,Daroff-Dell'Osso Ocular Motility Laboratory, Cleveland VA Medical Center, Cleveland, OH, United States
| | - Chrystalina Antoniades
- NeuroMetrology Lab, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - James Fitzgerald
- NeuroMetrology Lab, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.,Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - Fatema F Ghasia
- Daroff-Dell'Osso Ocular Motility Laboratory, Cleveland VA Medical Center, Cleveland, OH, United States.,Cole Eye Institute, Cleveland Clinic, Cleveland, OH, United States
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Puri S, Shaikh AG. Basic and translational neuro-ophthalmology of visually guided saccades: disorders of velocity. EXPERT REVIEW OF OPHTHALMOLOGY 2017; 12:457-473. [PMID: 30774705 PMCID: PMC6377082 DOI: 10.1080/17469899.2017.1395695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Saccades are rapid, yoked eye movements in an effort to direct a target over fovea. The complex circuitry of saccadic eye movements has been exhaustively described. As a result clinicians can elegantly localize the pathology if it falls on the neuraxis responsible for saccades. Traditionally saccades are studied with their quantitative characteristics such as amplitude, velocity, duration, direction, latency and accuracy. AREAS COVERED Amongst all subtypes, the physiology of the visually guided saccades is most extensively studied. Here we will review the basic and pertinent neuro-anatomy and physiology of visually guided saccade and then discuss common or classic disorders affecting the velocity of visually guided saccades. We will then discuss the basic mechanism for saccade slowing in these disorders. EXPERT COMMENTARY Prompt appreciation of disorders of saccade velocity is critical to reach appropriate diagnosis. Disorders of midbrain, cerebellum, or basal ganglia can lead to prolonged transition time during gaze shift and decreased saccade velocity.
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Affiliation(s)
- Sushant Puri
- Dept. of Neurology, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, Ohio, United States
| | - Aasef G. Shaikh
- Dept. of Neurology, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, Ohio, United States
- Daroff-DelOsso Ocular Motility Laboratory, Cleveland VA Medical Center, Cleveland, Ohio, United States
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Nguyen H, Lebel K, Bogard S, Goubault E, Boissy P, Duval C. Using Inertial Sensors to Automatically Detect and Segment Activities of Daily Living in People With Parkinson's Disease. IEEE Trans Neural Syst Rehabil Eng 2017; 26:197-204. [PMID: 28858808 DOI: 10.1109/tnsre.2017.2745418] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Wearable sensors such as inertial measurement units (IMUs) have been widely used to measure the quantity of physical activities during daily living in healthy and people with movement disorders through activity classification. These sensors have the potential to provide valuable information to evaluate the quality of the movement during the activities of daily living (ADL), such as walking, sitting down, and standing up, which could help clinicians to monitor rehabilitation and pharmaceutical interventions. However, high accuracy in the detection and segmentation of these activities is necessary for proper evaluation of the quality of the performance within a given segment. This paper presents algorithms to process IMU data, to detect and segment unstructured ADL in people with Parkinson's disease (PD) in simulated free-living environment. The proposed method enabled the detection of 1610 events of ADL performed by nine community dwelling older adults with PD under simulated free-living environment with 90% accuracy (sensitivity = 90.8%, specificity = 97.8%) while segmenting these activities within 350 ms of the "gold-standard" manual segmentation. These results demonstrate the robustness of the proposed method to eventually be used to automatically detect and segment ADL in free-living environment in people with PD. This could potentially lead to a more expeditious evaluation of the quality of the movement and administration of proper corrective care for patients who are under physical rehabilitation and pharmaceutical intervention for movement disorders.
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Manza P, Amandola M, Tatineni V, Li CSR, Leung HC. Response inhibition in Parkinson's disease: a meta-analysis of dopaminergic medication and disease duration effects. NPJ Parkinsons Dis 2017; 3:23. [PMID: 28702504 PMCID: PMC5501877 DOI: 10.1038/s41531-017-0024-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 06/07/2017] [Accepted: 06/16/2017] [Indexed: 12/24/2022] Open
Abstract
Parkinson's disease is a neurodegenerative disorder involving the basal ganglia that results in a host of motor and cognitive deficits. Dopamine-replacement therapy ameliorates some of the hallmark motor symptoms of Parkinson's disease, but whether these medications improve deficits in response inhibition, a critical executive function for behavioral control, has been questioned. Several studies of Parkinson's disease patients "on" and "off" (12-h withdrawal) dopaminergic medications suggested that dopamine-replacement therapy did not provide significant response inhibition benefits. However, these studies tended to include patients with moderate-to-advanced Parkinson's disease, when the efficacy of dopaminergic drugs is reduced compared to early-stage Parkinson's disease. In contrast, a few recent studies in early-stage Parkinson's disease report that dopaminergic drugs do improve response inhibition deficits. Based on these findings, we hypothesized that Parkinson's disease duration interacts with medication status to produce changes in cognitive function. To investigate this issue, we conducted a meta-analysis of studies comparing patients with Parkinson's disease and healthy controls on tests of response inhibition (50 comparisons from 42 studies). The findings supported the hypothesis; medication benefited response inhibition in patients with shorter disease duration, whereas "off" medication, moderate deficits were present that were relatively unaffected by disease duration. These findings support the role of dopamine in response inhibition and suggest the need to consider disease duration in research of the efficacy of dopamine-replacement therapy on cognitive function in Parkinson's disease.
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Affiliation(s)
- Peter Manza
- Department of Psychology, Stony Brook University, Stony Brook, NY 11790 USA
| | - Matthew Amandola
- Department of Psychology, Stony Brook University, Stony Brook, NY 11790 USA
| | | | - Chiang-shan R. Li
- Department of Psychiatry, Yale University, New Haven, CT 06519 USA
- Department of Neuroscience, Yale University, New Haven, CT 06520 USA
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT 06520 USA
- Beijing Huilongguan Hospital, Beijing, China
| | - Hoi-Chung Leung
- Department of Psychology, Stony Brook University, Stony Brook, NY 11790 USA
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The role of the prefrontal cortex in freezing of gait in Parkinson’s disease: insights from a deep repetitive transcranial magnetic stimulation exploratory study. Exp Brain Res 2017; 235:2463-2472. [DOI: 10.1007/s00221-017-4981-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 05/08/2017] [Indexed: 02/07/2023]
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Nguyen H, Lebel K, Boissy P, Bogard S, Goubault E, Duval C. Auto detection and segmentation of daily living activities during a Timed Up and Go task in people with Parkinson's disease using multiple inertial sensors. J Neuroeng Rehabil 2017; 14:26. [PMID: 28388939 PMCID: PMC5384139 DOI: 10.1186/s12984-017-0241-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 04/01/2017] [Indexed: 11/17/2022] Open
Abstract
Background Wearable sensors have the potential to provide clinicians with access to motor performance of people with movement disorder as they undergo intervention. However, sensor data often have to be manually classified and segmented before they can be processed into clinical metrics. This process can be time consuming. We recently proposed detection and segmentation algorithms based on peak detection using Inertial Measurement Units (IMUs) to automatically identify and isolate common activities during daily living such as standing up, walking, turning, and sitting down. These algorithms were developed using a homogenous population of healthy older adults. The aim of this study was to investigate the transferability of these algorithms in people with Parkinson’s disease (PD). Methods A modified Timed Up And Go task was used since it is comprised of these activities, all performed in a continuous fashion. Twelve older adults diagnosed with early PD (Hoehn & Yahr ≤ 2) were recruited for the study and performed three trials of a 10 and 5-m TUG during OFF state. They were outfitted with 17 IMUs covering each body segment. Raw data from IMUs were detrended, normalized and filtered to reveal kinematics peaks that corresponded to different activities. Segmentation was accomplished by identifying the first minimum or maximum to the right and the left of these peaks. Segmentation times were compared to results from two examiners who visually segmented the activities. Specificity and sensitivity were used to evaluate the accuracy of the detection algorithms. Results Using the same IMUs and algorithms developed in the previous study, we were able to detect these activities with 97.6% sensitivity and 92.7% specificity (n = 432) in PD population. However, with modifications to the IMUs selection, we were able to detect these activities with 100% accuracy. Similarly, applying the same segmentation to PD population, we were able to isolate these activities within ~500 ms of the visual segmentation. Re-optimizing the filtering frequencies, we were able to reduce this difference to ~400 ms. Conclusions This study demonstrates the agility and transferability of using a system of IMUs to accurately detect and segment activities in daily living in people with movement disorders.
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Affiliation(s)
- Hung Nguyen
- Département des Sciences de l'activité Physique, Université du Québec àMontréal, 141 Avenue du Président -Kennedy, Montréal, Québec, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Karina Lebel
- Faculty of Medicine and Health Sciences, Department of Surgery, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Research Center on Aging, Sherbrooke, Québec, Canada.,Interdisciplinary Institute for Technological Innovation (3IT), Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Patrick Boissy
- Faculty of Medicine and Health Sciences, Department of Surgery, Université de Sherbrooke, Sherbrooke, Québec, Canada.,Research Center on Aging, Sherbrooke, Québec, Canada.,Interdisciplinary Institute for Technological Innovation (3IT), Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Sarah Bogard
- Département des Sciences de l'activité Physique, Université du Québec àMontréal, 141 Avenue du Président -Kennedy, Montréal, Québec, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Etienne Goubault
- Département des Sciences de l'activité Physique, Université du Québec àMontréal, 141 Avenue du Président -Kennedy, Montréal, Québec, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Christian Duval
- Département des Sciences de l'activité Physique, Université du Québec àMontréal, 141 Avenue du Président -Kennedy, Montréal, Québec, Canada. .,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada.
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Soares SC, Maior RS, Isbell LA, Tomaz C, Nishijo H. Fast Detector/First Responder: Interactions between the Superior Colliculus-Pulvinar Pathway and Stimuli Relevant to Primates. Front Neurosci 2017; 11:67. [PMID: 28261046 PMCID: PMC5314318 DOI: 10.3389/fnins.2017.00067] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/30/2017] [Indexed: 12/17/2022] Open
Abstract
Primates are distinguished from other mammals by their heavy reliance on the visual sense, which occurred as a result of natural selection continually favoring those individuals whose visual systems were more responsive to challenges in the natural world. Here we describe two independent but also interrelated visual systems, one cortical and the other subcortical, both of which have been modified and expanded in primates for different functions. Available evidence suggests that while the cortical visual system mainly functions to give primates the ability to assess and adjust to fluid social and ecological environments, the subcortical visual system appears to function as a rapid detector and first responder when time is of the essence, i.e., when survival requires very quick action. We focus here on the subcortical visual system with a review of behavioral and neurophysiological evidence that demonstrates its sensitivity to particular, often emotionally charged, ecological and social stimuli, i.e., snakes and fearful and aggressive facial expressions in conspecifics. We also review the literature on subcortical involvement during another, less emotional, situation that requires rapid detection and response-visually guided reaching and grasping during locomotion-to further emphasize our argument that the subcortical visual system evolved as a rapid detector/first responder, a function that remains in place today. Finally, we argue that investigating deficits in this subcortical system may provide greater understanding of Parkinson's disease and Autism Spectrum disorders (ASD).
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Affiliation(s)
- Sandra C. Soares
- Department of Education and Psychology, CINTESIS.UA, University of AveiroAveiro, Portugal
- Division of Psychology, Department of Clinical Neuroscience, Karolinska InstituteStockholm, Sweden
- William James Research Center, Instituto Superior de Psicologia AplicadaLisbon, Portugal
| | - Rafael S. Maior
- Division of Psychology, Department of Clinical Neuroscience, Karolinska InstituteStockholm, Sweden
- Department of Physiological Sciences, Primate Center, Institute of Biology, University of BrasíliaBrasília, Brazil
| | - Lynne A. Isbell
- Department of Anthropology, University of California, DavisDavis, CA, USA
| | - Carlos Tomaz
- Department of Physiological Sciences, Primate Center, Institute of Biology, University of BrasíliaBrasília, Brazil
- Ceuma University, Neuroscience Research CoordinationSão Luis, Brazil
| | - Hisao Nishijo
- System Emotional Science, Graduate School of Medicine and Pharmaceutical Sciences, University of ToyamaToyama, Japan
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