1
|
Yeh CH, Xu Y, Shi W, Fitzgerald JJ, Green AL, Fischer P, Tan H, Oswal A. Auditory cues modulate the short timescale dynamics of STN activity during stepping in Parkinson's disease. Brain Stimul 2024; 17:501-509. [PMID: 38636820 PMCID: PMC7616027 DOI: 10.1016/j.brs.2024.04.006] [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] [Received: 01/16/2024] [Revised: 03/26/2024] [Accepted: 04/10/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Gait impairment has a major impact on quality of life in patients with Parkinson's disease (PD). It is believed that basal ganglia oscillatory activity at β frequencies (15-30 Hz) may contribute to gait impairment, but the precise dynamics of this oscillatory activity during gait remain unclear. Additionally, auditory cues are known to lead to improvements in gait kinematics in PD. If the neurophysiological mechanisms of this cueing effect were better understood they could be leveraged to treat gait impairments using adaptive Deep Brain Stimulation (aDBS) technologies. OBJECTIVE We aimed to characterize the dynamics of subthalamic nucleus (STN) oscillatory activity during stepping movements in PD and to establish the neurophysiological mechanisms by which auditory cues modulate gait. METHODS We studied STN local field potentials (LFPs) in eight PD patients while they performed stepping movements. Hidden Markov Models (HMMs) were used to discover transient states of spectral activity that occurred during stepping with and without auditory cues. RESULTS The occurrence of low and high β bursts was suppressed during and after auditory cues. This manifested as a decrease in their fractional occupancy and state lifetimes. Interestingly, α transients showed the opposite effect, with fractional occupancy and state lifetimes increasing during and after auditory cues. CONCLUSIONS We show that STN oscillatory activity in the α and β frequency bands are differentially modulated by gait-promoting oscillatory cues. These findings suggest that the enhancement of α rhythms may be an approach for ameliorating gait impairments in PD.
Collapse
Affiliation(s)
- Chien-Hung Yeh
- School of Information and Electronics, Beijing Institute of Technology, Beijing, China; Key Laboratory of Brain Health Intelligent Evaluation and Intervention, Ministry of Education (Beijing Institute of Technology), Beijing, China.
| | - Yifan Xu
- School of Information and Electronics, Beijing Institute of Technology, Beijing, China
| | - Wenbin Shi
- School of Information and Electronics, Beijing Institute of Technology, Beijing, China; Key Laboratory of Brain Health Intelligent Evaluation and Intervention, Ministry of Education (Beijing Institute of Technology), Beijing, China.
| | - James J Fitzgerald
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom; Oxford Functional Neurosurgery, John Radcliffe Hospital, Oxford, United Kingdom
| | - Alexander L Green
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom; Oxford Functional Neurosurgery, John Radcliffe Hospital, Oxford, United Kingdom
| | - Petra Fischer
- School of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol, United Kingdom
| | - Huiling Tan
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford, United Kingdom
| | - Ashwini Oswal
- MRC Brain Network Dynamics Unit, University of Oxford, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
| |
Collapse
|
2
|
Burrai F, Apuzzo L, Zanotti R. Effectiveness of Rhythmic Auditory Stimulation on Gait in Parkinson Disease: A Systematic Review and Meta-analysis. Holist Nurs Pract 2024; 38:109-119. [PMID: 34121062 DOI: 10.1097/hnp.0000000000000462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Parkinson disease is a neurodegenerative disease present in approximately 2% of the population older than 65 years. Rhythmic auditory stimulation in the early 1990s aimed to improve individual mobility in terms of gait speed, stride length, and cadence. Our systematic review and meta-analysis aimed to summarize and evaluate the evidence of the effects of rhythmic auditory stimulation on gait speed, stride length, and cadence in patients with Parkinson disease. A systematic review and meta-analysis of randomized controlled trials was conducted to determine the efficacy of rhythmic auditory stimulation in patients with Parkinson disease. Five studies were included in the review (209 patients). Rhythmic auditory stimulation resulted, on average, a gait speed improvement of 0.53 standard deviation (SD) units (95% CI, 0.23 to 0.83; P = .0005), a stride length improvement of 0.51 SD units (95% CI, 0.18 to 0.84; P = .003) greater than that in the control group. All trials contained a risk of bias due to a lack of blinding. The quality of evidence was low. No adverse events were identified. Rhythmic auditory stimulation may have a beneficial effect on gait speed and stride length in patients with Parkinson disease. Future studies should consider a power analysis to recruit an adequate number of subjects and minimize the risk of sample bias. Further research should provide the additional results required for an acceptable estimate of the effects of rhythmic auditory stimulation on gait in patients with Parkinson disease.
Collapse
Affiliation(s)
- Francesco Burrai
- SC Educational, Research and Organization, ATS Sardegna, Sassari, Italy (Dr Burrai); Carlo Chenis Hospice, Local Health Authority, ASL Roma 4, Civitavecchia, Italy (Mr Apuzzo); and Department of Medicine, University of Padova, Padova, Italy (Dr Zanotti)
| | | | | |
Collapse
|
3
|
Jordão S, Stergiou N, Brandão R, Pezarat-Correia P, Oliveira R, Cortes N, Vaz JR. Muscle activity variability patterns and stride to stride fluctuations of older adults are positively correlated during walking. Sci Rep 2023; 13:20721. [PMID: 38007498 PMCID: PMC10676363 DOI: 10.1038/s41598-023-47828-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 11/18/2023] [Indexed: 11/27/2023] Open
Abstract
It has been found that fractal-like patterns are present in the temporal structure of the variability of healthy biological rhythms, while pathology and disease lead to their deterioration. Interestingly, it has recently been suggested that these patterns in biological rhythms are related with each other, reflecting overall health or lack of it, due to their interaction. However, the underlying neurophysiological mechanisms responsible for such dependency remain unknown. In addition, this relationship between different elements needs to be first verified before we even pursue understanding their interaction. This study aimed to investigate the relationship between two elements of the neuromuscular system, gait and muscle activity variability patterns in older adults. Twenty-one older adults walked at their preferred walking speed on a treadmill. Inter-stride intervals were obtained through an accelerometer placed on the lateral malleoli to assess the temporal structure of variability of stride-to-stride fluctuations. Inter muscle peak intervals were obtained through the electromyographic signal of the gastrocnemius to assess the temporal structure of the variability of the simultaneous muscle activity. The temporal structure of variability from both signals was evaluated through the detrended fluctuation analysis, while their magnitude of variability was evaluated using the coefficient of variation. The Pearson's Correlation coefficient was used to identify the relationship between the two dependent variables. A significant strong positive correlation was found between the temporal structure of gait and muscle activity patterns. This result suggests that there is an interdependency between biological rhythms that compose the human neuromuscular system.
Collapse
Affiliation(s)
- Sofia Jordão
- CIPER, Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Campus Universitário, Quinta da Granja, Monte da Caparica, 2829 - 511, Caparica, Portugal
- Hospital da Ordem Terceira Chiado, Lisbon, Portugal
| | - Nick Stergiou
- Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE, USA
- Department of Physical Education and Sport Science, Aristotle University, Thessaloniki, Greece
| | - Rita Brandão
- CIPER, Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Pedro Pezarat-Correia
- CIPER, Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Raúl Oliveira
- CIPER, Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Nelson Cortes
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
- Department of Bioengineering, George Mason University, Fairfax, VA, USA
| | - João R Vaz
- CIPER, Neuromuscular Research Lab, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Campus Universitário, Quinta da Granja, Monte da Caparica, 2829 - 511, Caparica, Portugal.
- Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE, USA.
| |
Collapse
|
4
|
Gigonzac M, Terrier P. Restoring walking ability in older adults with arm-in-arm gait training: study protocol for the AAGaTT randomized controlled trial. BMC Geriatr 2023; 23:542. [PMID: 37674129 PMCID: PMC10481504 DOI: 10.1186/s12877-023-04255-9] [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] [Received: 02/08/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023] Open
Abstract
CONTEXT Falls are a significant problem among older adults. While balance and functional exercises have been shown to be effective, it remains unclear whether regular walking has specific effects on reducing the risk of falls. RATIONALE Older people who fall frequently have impaired gait patterns. Recent studies have suggested using interpersonal synchronization: while walking arm-in-arm, an older person synchronizes steps with a younger person to reinstate a better gait pattern. This method of gait training may reduce the risk of falls. OBJECTIVE The aim is to assess the efficacy of an arm-in-arm gait-training program in older people. DESIGN The arm-in-arm gait training trial (AAGaTT) is a single-site, open label, two-arm, randomized controlled trial. PARTICIPANTS We will enroll 66 dyads of older people and their younger "gait instructors". The older participants must be > 70 years old with adequate walking ability. They must have experienced a fall in the year prior to study entry. INTERVENTION Dyads will walk an indoor course for 30 min either side-by-side without contact (control group) or arm-in-arm while synchronizing their gait (intervention group). The gait training will be repeated three times a week for four weeks. OUTCOMES The main outcome will be the walking speed measured in five-minute walking trials performed at baseline and at the end of each intervention week (week 1 - week 4), and at week 7. Gait quality will be assessed using accelerometers. We will also assess perceived physical activity and health using questionnaires. Finally, we will monitor fall incidence over 18 months. We will evaluate whether outcomes are more improved in the intervention group compared to the control group. In addition, interviews will be conducted to assess the perception of the gait training. EXPECTED RESULTS Recent advances in the neurophysiology of motor control have shown that synchronizing gait to external cues or to a human partner can increase the efficiency of gait training. The expected benefits of arm-in-arm gait training are: reduced risk of falls, safe treatment with no adverse effects, and high adherence. This gait training program could be a low-cost intervention with positive effects on the health and well-being of seniors. TRIAL REGISTRATION ClinicalTrials.gov NCT05627453. Date of registration: 11.25.2022.
Collapse
Affiliation(s)
- Mathilde Gigonzac
- Haute Ecole Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, Neuchâtel, Switzerland
| | - Philippe Terrier
- Haute Ecole Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, Neuchâtel, Switzerland.
| |
Collapse
|
5
|
Mangalam M, Kelty-Stephen DG, Sommerfeld JH, Stergiou N, Likens AD. Temporal organization of stride-to-stride variations contradicts predictive models for sensorimotor control of footfalls during walking. PLoS One 2023; 18:e0290324. [PMID: 37616227 PMCID: PMC10449478 DOI: 10.1371/journal.pone.0290324] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/04/2023] [Indexed: 08/26/2023] Open
Abstract
Walking exhibits stride-to-stride variations. Given ongoing perturbations, these variations critically support continuous adaptations between the goal-directed organism and its surroundings. Here, we report that stride-to-stride variations during self-paced overground walking show cascade-like intermittency-stride intervals become uneven because stride intervals of different sizes interact and do not simply balance each other. Moreover, even when synchronizing footfalls with visual cues with variable timing of presentation, asynchrony in the timings of the cue and footfall shows cascade-like intermittency. This evidence conflicts with theories about the sensorimotor control of walking, according to which internal predictive models correct asynchrony in the timings of the cue and footfall from one stride to the next on crossing thresholds leading to the risk of falling. Hence, models of the sensorimotor control of walking must account for stride-to-stride variations beyond the constraints of threshold-dependent predictive internal models.
Collapse
Affiliation(s)
- Madhur Mangalam
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, United States of America
| | - Damian G. Kelty-Stephen
- Department of Psychology, State University of New York at New Paltz, New Paltz, NY, United States of America
| | - Joel H. Sommerfeld
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, United States of America
| | - Nick Stergiou
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, United States of America
- Department of Department of Physical Education, & Sport Science, Aristotle University, Thessaloniki, Greece
| | - Aaron D. Likens
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, United States of America
| |
Collapse
|
6
|
Current Treatments and New, Tentative Therapies for Parkinson’s Disease. Pharmaceutics 2023; 15:pharmaceutics15030770. [PMID: 36986631 PMCID: PMC10051786 DOI: 10.3390/pharmaceutics15030770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
Parkinson’s disease (PD) is a neurodegenerative pathology, the origin of which is associated with the death of neuronal cells involved in the production of dopamine. The prevalence of PD has increased exponentially. The aim of this review was to describe the novel treatments for PD that are currently under investigation and study and the possible therapeutic targets. The pathophysiology of this disease is based on the formation of alpha-synuclein folds that generate Lewy bodies, which are cytotoxic and reduce dopamine levels. Most pharmacological treatments for PD target alpha-synuclein to reduce the symptoms. These include treatments aimed at reducing the accumulation of alpha-synuclein (epigallocatechin), reducing its clearance via immunotherapy, inhibiting LRRK2, and upregulating cerebrosidase (ambroxol). Parkinson’s disease continues to be a pathology of unknown origin that generates a significant social cost for the patients who suffer from it. Although there is still no definitive cure for this disease at present, there are numerous treatments available aimed at reducing the symptomatology of PD in addition to other therapeutic alternatives that are still under investigation. However, the therapeutic approach to this pathology should include a combination of pharmacological and non-pharmacological strategies to maximise outcomes and improve symptomatological control in these patients. It is therefore necessary to delve deeper into the pathophysiology of the disease in order to improve these treatments and therefore the quality of life of the patients.
Collapse
|
7
|
Likens AD, Mangalam M, Wong AY, Charles AC, Mills C. Better than DFA? A Bayesian Method for Estimating the Hurst Exponent in Behavioral Sciences. ARXIV 2023:arXiv:2301.11262v1. [PMID: 36748008 PMCID: PMC9900970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Detrended Fluctuation Analysis (DFA) is the most popular fractal analytical technique used to evaluate the strength of long-range correlations in empirical time series in terms of the Hurst exponent, H. Specifically, DFA quantifies the linear regression slope in log-log coordinates representing the relationship between the time series' variability and the number of timescales over which this variability is computed. We compared the performance of two methods of fractal analysis-the current gold standard, DFA, and a Bayesian method that is not currently well-known in behavioral sciences: the Hurst-Kolmogorov (HK) method-in estimating the Hurst exponent of synthetic and empirical time series. Simulations demonstrate that the HK method consistently outperforms DFA in three important ways. The HK method: (i) accurately assesses long-range correlations when the measurement time series is short, (ii) shows minimal dispersion about the central tendency, and (iii) yields a point estimate that does not depend on the length of the measurement time series or its underlying Hurst exponent. Comparing the two methods using empirical time series from multiple settings further supports these findings. We conclude that applying DFA to synthetic time series and empirical time series during brief trials is unreliable and encourage the systematic application of the HK method to assess the Hurst exponent of empirical time series in behavioral sciences.
Collapse
Affiliation(s)
- Aaron D. Likens
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, 6160 University Dr S, Omaha, 68182, NE, USA
| | - Madhur Mangalam
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, 6160 University Dr S, Omaha, 68182, NE, USA
| | - Aaron Y. Wong
- Department of Educational Psychology, University of Minnesota, 56 East River Road, Minneapolis, 55415, MN, USA
| | - Anaelle C. Charles
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, 6160 University Dr S, Omaha, 68182, NE, USA
| | - Caitlin Mills
- Department of Educational Psychology, University of Minnesota, 56 East River Road, Minneapolis, 55415, MN, USA
| |
Collapse
|
8
|
Mangalam M, Skiadopoulos A, Siu KC, Mukherjee M, Likens A, Stergiou N. Leveraging a virtual alley with continuously varying width modulates step width variability during self-paced treadmill walking. Neurosci Lett 2023; 793:136966. [PMID: 36379391 PMCID: PMC10171215 DOI: 10.1016/j.neulet.2022.136966] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 11/15/2022]
Abstract
Increased fall risk in older adults and clinical populations is linked with increased amount and altered temporal structure of step width variability. One approach to rehabilitation seeks to reduce fall risk in older adults by reducing the amount of step width variability and restoring the temporal structure characteristic of healthy young adults. The success of such a program depends on our ability to modulate step width variability effectively. To this end, we investigated how manipulation of the visual walking space in a virtual environment could modulate the amount and temporal structure of step width variability. Nine healthy adults performed self-paced treadmill walking in a virtual alley in a fixed-width Control condition (1.91 m) and two conditions in which the alley's width oscillated sinusoidally at 0.03 Hz: between 0.38 and 1.14 m and 0.38-2.67 m in Narrow and Wide conditions, respectively. The step width time series from each condition was evaluated using: (i) the standard deviation to identify changes in the amount of variability and (ii) the fractal scaling exponent estimated using detrended fluctuation analysis (DFA) to identify changes in the temporal structure of variability in terms of persistence in fluctuations. The Wide condition neither affected the standard deviation nor the fractal scaling exponent of step width time series. The Narrow condition did not affect the standard deviation of step width time series compared to the Control condition but significantly increased its fractal scaling exponent compared to the Control and Wide conditions, suggestive of more persistent fluctuations characteristic of a healthy gait. These results show that virtual reality based rehabilitative intervention can modulate step width variability to potentially reduce fall risk in older adults and clinical populations.
Collapse
Affiliation(s)
- Madhur Mangalam
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, NE 68182, USA.
| | - Andreas Skiadopoulos
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, NE 68182, USA
| | - Ka-Chun Siu
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, NE 68182, USA; College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Mukul Mukherjee
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, NE 68182, USA
| | - Aaron Likens
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, NE 68182, USA
| | - Nick Stergiou
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, NE 68182, USA.
| |
Collapse
|
9
|
Guo Y, Yang J, Liu Y, Chen X, Yang GZ. Detection and assessment of Parkinson's disease based on gait analysis: A survey. Front Aging Neurosci 2022; 14:916971. [PMID: 35992585 PMCID: PMC9382193 DOI: 10.3389/fnagi.2022.916971] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
Neurological disorders represent one of the leading causes of disability and mortality in the world. Parkinson's Disease (PD), for example, affecting millions of people worldwide is often manifested as impaired posture and gait. These impairments have been used as a clinical sign for the early detection of PD, as well as an objective index for pervasive monitoring of the PD patients in daily life. This review presents the evidence that demonstrates the relationship between human gait and PD, and illustrates the role of different gait analysis systems based on vision or wearable sensors. It also provides a comprehensive overview of the available automatic recognition systems for the detection and management of PD. The intervening measures for improving gait performance are summarized, in which the smart devices for gait intervention are emphasized. Finally, this review highlights some of the new opportunities in detecting, monitoring, and treating of PD based on gait, which could facilitate the development of objective gait-based biomarkers for personalized support and treatment of PD.
Collapse
Affiliation(s)
- Yao Guo
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China
| | - Jianxin Yang
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China
| | - Yuxuan Liu
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China
| | - Xun Chen
- Department of Electronic Engineering and Information Science, University of Science and Technology of China, Hefei, China
| | - Guang-Zhong Yang
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
10
|
Lheureux A, Warlop T, Cambier C, Chemin B, Stoquart G, Detrembleur C, Lejeune T. Influence of Autocorrelated Rhythmic Auditory Stimulations on Parkinson's Disease Gait Variability: Comparison With Other Auditory Rhythm Variabilities and Perspectives. Front Physiol 2021; 11:601721. [PMID: 33424625 PMCID: PMC7786048 DOI: 10.3389/fphys.2020.601721] [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: 09/01/2020] [Accepted: 12/04/2020] [Indexed: 11/13/2022] Open
Abstract
Parkinson's Disease patients suffer from gait impairments such as reduced gait speed, shortened step length, and deterioration of the temporal organization of stride duration variability (i.e., breakdown in Long-Range Autocorrelations). The aim of this study was to compare the effects on Parkinson's Disease patients' gait of three Rhythmic Auditory Stimulations (RAS), each structured with a different rhythm variability (isochronous, random, and autocorrelated). Nine Parkinson's Disease patients performed four walking conditions of 10-15 min each: Control Condition (CC), Isochronous RAS (IRAS), Random RAS (RRAS), and Autocorrelated RAS (ARAS). Accelerometers were used to assess gait speed, cadence, step length, temporal organization (i.e., Long-Range Autocorrelations computation), and magnitude (i.e., coefficient of variation) of stride duration variability on 512 gait cycles. Long-Range Autocorrelations were assessed using the evenly spaced averaged Detrended Fluctuation Analysis (α-DFA exponent). Spatiotemporal gait parameters and coefficient of variation were not modified by the RAS. Long-Range Autocorrelations were present in all patients during CC and ARAS although all RAS conditions altered them. The α-DFA exponents were significantly lower during IRAS and RRAS than during CC, exhibiting anti-correlations during IRAS in seven patients. α-DFA during ARAS was the closest to the α-DFA during CC and within normative data of healthy subjects. In conclusion, Isochronous RAS modify patients' Long-Range Autocorrelations and the use of Autocorrelated RAS allows to maintain an acceptable level of Long-Range Autocorrelations for Parkinson's Disease patients' gait.
Collapse
Affiliation(s)
- Alexis Lheureux
- Institute of NeuroScience, Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium.,Department of Physical and Rehabilitation Medicine, Cliniques universitaires Saint-Luc, Woluwe-Saint-Lambert, Belgium
| | - Thibault Warlop
- Institute of NeuroScience, Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium
| | - Charline Cambier
- NeuroMusculoSkeletal Lab (NSMK), Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium
| | - Baptiste Chemin
- Institute of NeuroScience, Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium
| | - Gaëtan Stoquart
- Department of Physical and Rehabilitation Medicine, Cliniques universitaires Saint-Luc, Woluwe-Saint-Lambert, Belgium.,NeuroMusculoSkeletal Lab (NSMK), Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium
| | - Christine Detrembleur
- NeuroMusculoSkeletal Lab (NSMK), Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium
| | - Thierry Lejeune
- Department of Physical and Rehabilitation Medicine, Cliniques universitaires Saint-Luc, Woluwe-Saint-Lambert, Belgium.,NeuroMusculoSkeletal Lab (NSMK), Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Woluwe-Saint-Lambert, Belgium
| |
Collapse
|