1
|
Lambert KJM, Singhal A, Leung AWS. The lateralized effects of Parkinson's Disease on motor imagery: Evidence from mental chronometry. Brain Cogn 2024; 178:106181. [PMID: 38796902 DOI: 10.1016/j.bandc.2024.106181] [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: 03/18/2024] [Revised: 05/17/2024] [Accepted: 05/17/2024] [Indexed: 05/29/2024]
Abstract
Alterations to the content of action representations may contribute to the movement challenges that characterize Parkinson's Disease (PD). One way to investigate action representations is through motor imagery. As PD motor symptoms typically have a unilateral onset, disease-related deficits related to action representations may follow a similarly lateralized pattern. The present study examined if temporal accuracy of motor imagery in individuals with PD differed according to the side of the body involved in the task. Thirty-eight participants with PD completed a mental chronometry task using their more affected and less affected side. Participants had significantly shorter mental versus physical movement times for the more affected. Higher imagery vividness in the kinaesthetic domain predicted shorter mental versus physical movement times for the more affected side, as did lower imagery vividness in the visual domain and poorer cognitive function. These results indicate that people with PD imagine movements differently when the target actions their more affected versus less affected side. It is additionally possible that side-specific deficits in the accurate processing of kinaesthetic information lead to an increased reliance on visual processes and cognitive resources to successfully execute motor imagery involving the more affected side.
Collapse
Affiliation(s)
- Kathryn J M Lambert
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Canada.
| | - Anthony Singhal
- Department of Psychology, Faculty of Science, University of Alberta, Canada; Neuroscience and Mental Health Institute, University of Alberta, Canada
| | - Ada W S Leung
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Canada; Neuroscience and Mental Health Institute, University of Alberta, Canada
| |
Collapse
|
2
|
Albanese GA, Basile E, Momi ED, Zenzeri J. A new robot-based proprioceptive training algorithm to induce sensorimotor enhancement in the human wrist. IEEE Int Conf Rehabil Robot 2022; 2022:1-6. [PMID: 36176156 DOI: 10.1109/icorr55369.2022.9896533] [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: 06/16/2023]
Abstract
Afferent proprioceptive signals, responsible for body awareness, have a crucial role when planning and executing motor tasks. Increasing evidence suggests that proprioceptive sensory training may improve motor performance. Although this topic had been partially investigated, there was a lack of studies involving the wrist joint. Proprioception at the wrist level is particularly relevant to interact with the environment through actions that require an accurate sense of position and motion, and fine haptic perception. In this study, we implemented and tested a robotic training algorithm of human wrist proprioception. The proposed task was a continuous tracking in the workspace identified by flexion-extension and radial-ulnar deviation movements. Healthy subjects were haptically guided towards the target, without any visual feedback of the position of the end- effector. Our results showed that, after the training, participants improved their motor performance in a different tracking task, completely active and with visual feedback Additionally, the training led them to more efficient use of kinesthetic feedback during haptically-guided reaching tasks. Our findings demonstrated that the proposed training algorithm of wrist proprioception induced a task-specific sensorimotor enhancement. From the perspective of a rehabilitative intervention, this robot-based training has the potential to improve motor functions and the quality of life of subjects with sensorimotor deficits.
Collapse
|
3
|
Flouty O, Yamamoto K, Germann J, Harmsen IE, Jung HH, Cheyuo C, Zemmar A, Milano V, Sarica C, Lozano AM. Idiopathic Parkinson's disease and chronic pain in the era of deep brain stimulation: a systematic review and meta-analysis. J Neurosurg 2022; 137:1821-1830. [PMID: 35535836 DOI: 10.3171/2022.2.jns212561] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 02/21/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Pain is the most common nonmotor symptom of Parkinson's disease (PD) and is often undertreated. Deep brain stimulation (DBS) effectively mitigates the motor symptoms of this multisystem neurodegenerative disease; however, its therapeutic effect on nonmotor symptoms, especially pain, remains inconclusive. While there is a critical need to help this large PD patient population, guidelines for managing this significant disease burden are absent. Herein, the authors systematically reviewed the literature and conducted a meta-analysis to study the influence of traditional (subthalamic nucleus [STN] and globus pallidus internus [GPi]) DBS on chronic pain in patients with PD. METHODS The authors performed a systematic review of the literature and a meta-analysis following PRISMA guidelines. Risk of bias was assessed using the levels of evidence established by the Oxford Centre for Evidence-Based Medicine. Inclusion criteria were articles written in English, published in a peer-reviewed scholarly journal, and about studies conducting an intervention for PD-related pain in no fewer than 5 subjects. RESULTS Twenty-six studies were identified and included in this meta-analysis. Significant interstudy heterogeneity was detected (Cochran's Q test p < 0.05), supporting the use of the random-effects model. The random-effects model estimated the effect size of DBS for the treatment of idiopathic pain as 1.31 (95% CI 0.84-1.79). The DBS-on intervention improved pain scores by 40% as compared to the control state (preoperative baseline or DBS off). CONCLUSIONS The results indicated that traditional STN and GPi DBS can have a favorable impact on pain control and improve pain scores by 40% from baseline in PD patients experiencing chronic pain. Further trials are needed to identify the subtype of PD patients whose pain benefits from DBS and to identify the mechanisms by which DBS improves pain in PD patients.
Collapse
Affiliation(s)
- Oliver Flouty
- 1Department of Neurosurgery, University of South Florida, Tampa, Florida
| | - Kazuaki Yamamoto
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Jurgen Germann
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Irene E Harmsen
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Hyun Ho Jung
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,3Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Cletus Cheyuo
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Ajmal Zemmar
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,4Department of Neurosurgery, University of Louisville, School of Medicine, Louisville, Kentucky; and.,5Department of Neurosurgery, Henan Provincial People's Hospital, Henan University People's Hospital, Henan University School of Medicine, Zhengzhou, China
| | - Vanessa Milano
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Can Sarica
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Andres M Lozano
- 2Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
4
|
The Effect of Whole-Body Vibration on Proprioception and Motor Function for Individuals with Moderate Parkinson Disease: A Single-Blind Randomized Controlled Trial. Occup Ther Int 2022; 2021:9441366. [PMID: 34992511 PMCID: PMC8709745 DOI: 10.1155/2021/9441366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/22/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Previous studies have shown that whole-body vibration (WBV) may have a potential impact on gait and balance in individuals with Parkinson's disease (PD). However, this body of work has proven inconclusive due to the diverse disease progression and broad age range associated with PD. The effects of WBV on proprioception, a sense frequently affected by PD, has rarely been studied. Objective To investigate the short-term effect of WBV on proprioception and motor function for individual with moderate PD. Design A single-blind randomized controlled trial. Setting. A hospital and a laboratory. Participants. 32 participants with moderate PD were recruited and randomly assigned into either the WBV or conventional therapy groups. Interventions. For the WBV group, each treatment session included five, one-minute bouts of whole-body vibration paired with one-minute rest (frequency: 6 Hz; amplitude: 3 mm). Each conventional therapy participant received balance and mobility training for 10 minutes. Main Outcome Measures. Outcome measures included proprioceptive sensitivity of the upper limb, position sense of the knee joint, Unified Parkinson's disease rating scale : motor section (UPDRS-motor), functional reach test (FRT), and the timed up and go test (TUG). Results No statistically significant difference was found between groups. However, both groups showed a significant improvement in motor function after treatment, including UPDRS-motor (P = 0.04), less affected side of FRT (P = 0.019), and TUG (P = 0.006). Conclusions Although the effect of WBV was not superior to the conventional therapy, it provided a passive and safe clinical intervention as an alternative treatment, especially for individuals with motor impairment or poor balance function.
Collapse
|
5
|
Effect of External Feedback on Bimanual Coordination Control in Patients with Parkinson's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010927. [PMID: 34682672 PMCID: PMC8536089 DOI: 10.3390/ijerph182010927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/07/2021] [Accepted: 10/16/2021] [Indexed: 11/17/2022]
Abstract
Bimanual coordination control requires task-specific control of the spatial and temporal characteristics of the coupling of both upper limbs. The present study examined the effects of external feedback (i.e., auditory signal) on bimanual coordination movement during patients with Parkinson’s disease (PD). Twelve PD patients in advanced stages and 12 early stages of untreated PD patients, and 12 age-matched normal adults were instructed to perform bimanual coordination control using preference (1 Hz) and fast (1.75 Hz) speeds with metronome auditory cue. The results demonstrated that the advanced PD patients showed reduced synchronized bimanual coordination control during the anti-phase movement compared with other two groups. Moreover, the decreased movement accuracy was exhibited not only at the preference speed, but also more particularly at the fast speed with anti-phase rather than in-phase movement. This suggests that PD results in impairments in scaling the bimanual movement speed and amplitude of limb, and these deficits were more pronounced as a function of movement control speed. Overall, the current data provide evidence of the pathophysiology of the basal ganglia on the bimanual coordination movement.
Collapse
|
6
|
Spitzley KA, Karduna AR. Joint Position Accuracy Is Influenced by Visuoproprioceptive Congruency in Virtual Reality. J Mot Behav 2021; 54:92-101. [PMID: 34121630 DOI: 10.1080/00222895.2021.1916425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Weighted integration of visual and proprioceptive information is important in movement planning and execution. The present study used a virtual reality system to determine how upper limb movement consistency and accuracy are altered when (a) vision of the limb is removed and (b) proprioception and vision of the limb are misaligned. A one degree of freedom upper limb movement task was performed under three visual conditions of the limb; accurate vision, no vision, and offset vision. Movement consistency was unaltered by the change in visual condition. Compared to the accurate vision condition, movement accuracy was unchanged in the no vision condition but decreased with a visual offset. When available, vision was relied upon more heavily than proprioception for task completion.
Collapse
Affiliation(s)
- Kate A Spitzley
- Department of Human Physiology, University of Oregon, Eugene, OR, USA
| | - Andrew R Karduna
- Department of Human Physiology, University of Oregon, Eugene, OR, USA
| |
Collapse
|
7
|
Albanese GA, Holmes MWR, Marini F, Morasso P, Zenzeri J. Wrist Position Sense in Two Dimensions: Between-Hand Symmetry and Anisotropic Accuracy Across the Space. Front Hum Neurosci 2021; 15:662768. [PMID: 33967724 PMCID: PMC8100524 DOI: 10.3389/fnhum.2021.662768] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/29/2021] [Indexed: 02/01/2023] Open
Abstract
A deep investigation of proprioceptive processes is necessary to understand the relationship between sensory afferent inputs and motor outcomes. In this work, we investigate whether and how perception of wrist position is influenced by the direction along which the movement occurs. Most previous studies have tested Joint Position Sense (JPS) through 1 degree of freedom (DoF) wrist movements, such as flexion/extension (FE) or radial/ulnar deviation (RUD). However, the wrist joint has 3-DoF and many activities of daily living produce combined movements, requiring at least 2-DoF wrist coordination. For this reason, in this study, target positions involved movement directions that combined wrist flexion or extension with radial or ulnar deviation. The chosen task was a robot-aided Joint Position Matching (JPM), in which blindfolded participants actively reproduced a previously passively assumed target joint configuration. The JPM performance of 20 healthy participants was quantified through measures of accuracy and precision, in terms of both perceived target direction and distance along each direction of movement. Twelve different directions of movement were selected and both hands tested. The left and right hand led to comparable results, both target extents and directions were differently perceived according to the target direction on the FE/RUD space. Moreover, during 2-DoF combined movements, subjects' perception of directions was impaired when compared to 1-DoF target movements. In summary, our results showed that human perception of wrist position on the FE/RUD space is symmetric between hands but not isotropic among movement directions.
Collapse
Affiliation(s)
- Giulia A Albanese
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy.,Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genoa, Genoa, Italy
| | - Michael W R Holmes
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | | | - Pietro Morasso
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
| | - Jacopo Zenzeri
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
| |
Collapse
|
8
|
Cressman EK, Salomonczyk D, Constantin A, Miyasaki J, Moro E, Chen R, Strafella A, Fox S, Lang AE, Poizner H, Henriques DYP. Proprioceptive recalibration following implicit visuomotor adaptation is preserved in Parkinson's disease. Exp Brain Res 2021; 239:1551-1565. [PMID: 33688984 DOI: 10.1007/s00221-021-06075-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 02/26/2021] [Indexed: 10/21/2022]
Abstract
Individuals with Parkinson's disease (PD) and healthy adults demonstrate similar levels of visuomotor adaptation provided that the distortion is small or introduced gradually, and hence, implicit processes are engaged. Recently, implicit processes underlying visuomotor adaptation in healthy individuals have been proposed to include proprioceptive recalibration (i.e., shifts in one's proprioceptive sense of felt hand position to match the visual estimate of their hand experienced during reaches with altered visual feedback of the hand). In the current study, we asked if proprioceptive recalibration is preserved in PD patients. PD patients tested during their "off" and "on" medication states and age-matched healthy controls reached to visual targets, while visual feedback of their unseen hand was gradually rotated 30° clockwise or translated 4 cm rightwards of their actual hand trajectory. As expected, PD patients and controls produced significant reach aftereffects, indicating visuomotor adaptation after reaching with the gradually introduced visuomotor distortions. More importantly, following visuomotor adaptation, both patients and controls showed recalibration in hand position estimates, and the magnitude of this recalibration was comparable between PD patients and controls. No differences for any measures assessed were observed across medication status (i.e., PD off vs PD on). Results reveal that patients are able to adjust their sensorimotor mappings and recalibrate proprioception following adaptation to a gradually introduced visuomotor distortion, and that dopaminergic intervention does not affect this proprioceptive recalibration. These results suggest that proprioceptive recalibration does not involve striatal dopaminergic pathways and may contribute to the preserved visuomotor adaptation that arises implicitly in PD patients.
Collapse
Affiliation(s)
- Erin K Cressman
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Danielle Salomonczyk
- Department of Psychology, York University, Toronto, Canada.,Centre for Vision Research, York University, Toronto, Canada
| | | | - Janis Miyasaki
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada
| | - Elena Moro
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada
| | - Robert Chen
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada
| | - Antonio Strafella
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada
| | - Susan Fox
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada
| | - Anthony E Lang
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, Toronto, Canada
| | - Howard Poizner
- Institute for Neural Computation, University of California, San Diego, USA
| | - Denise Y P Henriques
- Centre for Vision Research, York University, Toronto, Canada. .,Department of Kinesiology, School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
| |
Collapse
|
9
|
Stability of Action and Kinesthetic Perception in Parkinson's Disease. J Hum Kinet 2021; 76:145-159. [PMID: 33603931 PMCID: PMC7877286 DOI: 10.2478/hukin-2021-0006] [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] [Indexed: 11/20/2022] Open
Abstract
We present a review of action and perception stability within the theoretical framework based on the idea of control with spatial referent coordinates for the effectors at a number of hierarchical levels. Stability of salient variables is ensured by synergies, neurophysiological structures that act in multi-dimensional spaces of elemental variables and limit variance to the uncontrolled manifold during action and iso-perceptual manifold during perception. Patients with Parkinson’s disease show impaired synergic control reflected in poor stability (low synergy indices) and poor agility (low indices of anticipatory synergy adjustments prior to planned quick actions). They also show impaired perception across modalities, including kinesthetic perception. We suggest that poor stability at the level of referent coordinates can be the dominant factor leading to poor stability of percepts.
Collapse
|
10
|
Hensel L, Hoffstaedter F, Caspers J, Michely J, Mathys C, Heller J, Eickhoff CR, Reetz K, Südmeyer M, Fink GR, Schnitzler A, Grefkes C, Eickhoff SB. Functional Connectivity Changes of Key Regions for Motor Initiation in Parkinson's Disease. Cereb Cortex 2020; 29:383-396. [PMID: 30418548 PMCID: PMC6294405 DOI: 10.1093/cercor/bhy259] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Indexed: 11/13/2022] Open
Abstract
Akinesia, a cardinal symptom of Parkinson's disease, has been linked to abnormal activation in putamen and posterior medial frontal cortex (pMFC). However, little is known whether clinical severity of akinesia is linked to dysfunctional connectivity of these regions. Using a seed-based approach, we here investigated resting-state functional connectivity (RSFC) of putamen, pMFC and primary motor cortex (M1) in 60 patients with Parkinson's disease on regular medication and 72 healthy controls. We found that in patients putamen featured decreases of connectivity for a number of cortical and subcortical areas engaged in sensorimotor and cognitive processing. In contrast, the pMFC showed reduced connectivity with a more focal cortical network involved in higher-level motor-cognition. Finally, M1 featured a selective disruption of connectivity in a network specifically connected with M1. Correlating clinical impairment with connectivity changes revealed a relationship between akinesia and reduced RSFC between pMFC and left intraparietal lobule (IPL). Together, the present study demonstrated RSFC decreases in networks for motor initiation and execution in Parkinson's disease. Moreover, results suggest a relationship between pMFC-IPL decoupling and the manifestation of akinetic symptoms.
Collapse
Affiliation(s)
- Lukas Hensel
- Department of Neurology, Cologne University Hospital, Cologne, Germany.,Institute of Neuroscience and Medicine, (INM-3: Cognitive Neuroscience), Research Centre Jülich, Jülich, Germany
| | - Felix Hoffstaedter
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Institute of Neuroscience and Medicine, (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
| | - Julian Caspers
- Institute of Neuroscience and Medicine, (INM1: Structural and Functional Organization of the Brain), Research Centre Jülich, Jülich, Germany.,Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | - Jochen Michely
- Department of Neurology, Cologne University Hospital, Cologne, Germany.,Wellcome Centre for Human Neuroimaging, University College London, London, UK
| | - Christian Mathys
- Department of Diagnostic and Interventional Radiology, University Du¨sseldorf, Medical Faculty, Düsseldorf, Germany
| | - Julia Heller
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Research Centre Jülich, Jülich, Germany
| | - Claudia R Eickhoff
- Institute of Neuroscience and Medicine, (INM1: Structural and Functional Organization of the Brain), Research Centre Jülich, Jülich, Germany.,Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University, Düsseldorf, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Research Centre Jülich, Jülich, Germany
| | - Martin Südmeyer
- Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University, Düsseldorf, Germany.,Medical Faculty, Department of Neurology, Center for Movement Disorders and Neuromodulation, Heinrich Heine University, Düsseldorf, Germany
| | - Gereon R Fink
- Department of Neurology, Cologne University Hospital, Cologne, Germany.,Institute of Neuroscience and Medicine, (INM-3: Cognitive Neuroscience), Research Centre Jülich, Jülich, Germany
| | - Alfons Schnitzler
- Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University, Düsseldorf, Germany.,Medical Faculty, Department of Neurology, Center for Movement Disorders and Neuromodulation, Heinrich Heine University, Düsseldorf, Germany
| | - Christian Grefkes
- Department of Neurology, Cologne University Hospital, Cologne, Germany.,Institute of Neuroscience and Medicine, (INM-3: Cognitive Neuroscience), Research Centre Jülich, Jülich, Germany
| | - Simon B Eickhoff
- Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,Institute of Neuroscience and Medicine, (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
| |
Collapse
|
11
|
Bong SM, McKay JL, Factor SA, Ting LH. Perception of whole-body motion during balance perturbations is impaired in Parkinson's disease and is associated with balance impairment. Gait Posture 2020; 76:44-50. [PMID: 31731133 PMCID: PMC7015810 DOI: 10.1016/j.gaitpost.2019.10.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 09/09/2019] [Accepted: 10/22/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND In addition to motor deficits, Parkinson's disease (PD) may cause perceptual impairments. The role of perceptual impairments in sensorimotor function is unclear, and has typically been studied in single-joint motions. RESEARCH QUESTION We hypothesized that perception of whole-body motion is impaired in PD and contributes to balance impairments. We tested (1) whether directional acuity to whole body perturbations during standing was worse in people with PD compared to neurotypical older adults (NOA), and (2) whether balance ability, as assessed by the MiniBESTest, was associated with poor directional acuity in either group. METHODS Participants were exposed to pairs of support-surface translation perturbations in a two-alternative forced choice testing paradigm developed previously in a young healthy population. The first perturbation of each pair that was to be judged by participants was directly backward, and the second perturbation deviated from the left or right from the backward direction by 1°-44°. Participants reported whether the perturbations in each pair were in the "same" or "different" direction. Judgements from 24 to 67 perturbation pairs were used to calculate directional acuity thresholds corresponding to "just-noticeable differences" in perturbation direction. Linear mixed models determined associations between directional thresholds and clinical variables including MDS-UPDRS-III score, age, and MiniBESTest score. RESULTS 20 PD (64 ± 7 y, 12 male, ≥12 h since last intake of antiparkinsonian medications) and 12 NOA (64 ± 8, 6 male) were assessed. Directional thresholds were higher (worse) among PD participants (17.6 ± 5.9° vs. 12.8 ± 3.3°, P < 0.01). Linear mixed models further showed that higher thresholds were associated with MDS-UPDRS-III score (P < 0.01), and were associated with poorer balance ability among PD participants (P < 0.01), but not among NOA participants (P = 0.40). SIGNIFICANCE Perception of whole-body motion is impaired in PD and may contribute to impaired balance and falls.
Collapse
Affiliation(s)
- Sistania M. Bong
- Wallace H. Coulter Department of Biomedical Engineering,
Emory University and Georgia Tech, Atlanta, Georgia, USA
| | - J. Lucas McKay
- Wallace H. Coulter Department of Biomedical Engineering,
Emory University and Georgia Tech, Atlanta, Georgia, USA
| | - Stewart A. Factor
- Jean & Paul Amos PD & Movement Disorders Program,
Department of Neurology, Emory University School of Medicine, Atlanta, Georgia,
USA
| | - Lena H. Ting
- Wallace H. Coulter Department of Biomedical Engineering,
Emory University and Georgia Tech, Atlanta, Georgia, USA.,Division of Physical Therapy, Department of Rehabilitation
Medicine, Emory University School of Medicine, Atlanta, Georgia, USA,Corresponding author Lena H. Ting PhD, Wallace H.
Coulter Department of Biomedical Engineering, Emory University and the Georgia
Institute of Technology, 1760 Haygood Drive, Suite W200, Atlanta, Georgia,
30322, USA,
| |
Collapse
|
12
|
Parlikar R, Bose A, Venkatasubramanian G. Schizophrenia and Corollary Discharge: A Neuroscientific Overview and Translational Implications. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2019; 17:170-182. [PMID: 30905117 PMCID: PMC6478093 DOI: 10.9758/cpn.2019.17.2.170] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 07/25/2018] [Accepted: 08/02/2018] [Indexed: 01/10/2023]
Abstract
Corollary discharge mechanism refers to the suppression of sensory consequences of self-generated actions; a process that serves to distinguish between self and non-self based on discrimination of origination of action. It explains, say for example, why we cannot tickle ourselves. This review discusses how corollary discharge model is an essential neural integration mechanism central to the motor functioning of animal kingdom. In this article, research conducted in the field of corollary discharge has been reviewed to understand the neuroanatomical and neurophysiological basis of corollary discharge and gain insight into the biochemical basis of its dysfunction. This review article also explores the role of corollary discharge and its dysfunction in the presentation of symptoms of schizophrenia, discussing the findings from corollary discharge studies on schizophrenia population. Lastly, the link between schizophrenia psychopathology and corollary discharge dysfunction has been highlighted, and an attempt has been made to establish a case for correction of corollary discharge deficit in schizophrenia through neuromodulation.
Collapse
Affiliation(s)
- Rujuta Parlikar
- WISER Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Anushree Bose
- WISER Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Ganesan Venkatasubramanian
- WISER Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| |
Collapse
|
13
|
Attenuated beta rebound to proprioceptive afferent feedback in Parkinson's disease. Sci Rep 2019; 9:2604. [PMID: 30796340 PMCID: PMC6385616 DOI: 10.1038/s41598-019-39204-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 01/21/2019] [Indexed: 11/09/2022] Open
Abstract
Motor symptoms are defining traits in the diagnosis of Parkinson’s disease (PD). A crucial component in motor function is the integration of afferent proprioceptive sensory feedback. Previous studies have indicated abnormal movement-related cortical oscillatory activity in PD, but the role of the proprioceptive afference on abnormal oscillatory activity in PD has not been elucidated. We examine the cortical oscillations in the mu/beta-band (8–30 Hz) in the processing of proprioceptive stimulation in PD patients, ON/OFF levodopa medication, as compared to that of healthy controls (HC). We used a proprioceptive stimulator that generated precisely controlled passive movements of the index finger and measured the induced cortical oscillatory responses following the proprioceptive stimulation using magnetoencephalography. Both PD patients and HC showed a typical beta-band desynchronization during the passive movement. However, the subsequent beta rebound after the passive movement that was almost absent in PD patients compared to HC. Furthermore, we found no difference in the degree of beta rebound attenuation between patients ON and OFF levodopa medication. The results demonstrate a disease-related deterioration in cortical processing of proprioceptive afference in PD.
Collapse
|
14
|
Cuppone AV, Cappagli G, Gori M. Audio Feedback Associated With Body Movement Enhances Audio and Somatosensory Spatial Representation. Front Integr Neurosci 2018; 12:37. [PMID: 30233334 PMCID: PMC6131311 DOI: 10.3389/fnint.2018.00037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 08/15/2018] [Indexed: 11/13/2022] Open
Abstract
In the last years, the positive impact of sensorimotor rehabilitation training on spatial abilities has been taken into account, e.g., providing evidence that combined multimodal compared to unimodal feedback improves responsiveness to spatial stimuli. To date, it still remains unclear to which extent spatial learning is influenced by training conditions. Here we investigated the effects of active and passive audio-motor training on spatial perception in the auditory and proprioceptive domains on 36 healthy young adults. First, to investigate the role of voluntary movements on spatial perception, we compared the effects of active vs. passive multimodal training on auditory and proprioceptive spatial localization. Second, to investigate the effectiveness of unimodal training conditions on spatial perception, we compared the impact of only proprioceptive or only auditory sensory feedback on spatial localization. Finally, to understand whether the positive effects of multimodal and unimodal trainings generalize to the untrained part, both dominant and non-dominant arms were tested. Results indicate that passive multimodal training (guided movement) is more beneficial than active multimodal training (active exploration) and only in passive condition the improvement is generalized also on the untrained hand. Moreover, we found that combined audio-motor training provides the strongest benefit because it significantly affects both auditory and somatosensory localization, while the effect of a single feedback modality is limited to a single domain, indicating a cross-modal influence of the two domains. Therefore, the use of multimodal feedback is more efficient in improving spatial perception. These results indicate that combined sensorimotor signals are effective in recalibrating auditory and proprioceptive spatial perception and that the beneficial effect is mainly due to the combination of auditory and proprioceptive spatial cues.
Collapse
Affiliation(s)
- Anna Vera Cuppone
- Unit for Visually Impaired People (U-VIP), Istituto Italiano di Tecnologia, Genoa, Italy
| | | | | |
Collapse
|
15
|
Park JH, Kim D, Park H, Jung I, Youn I, Park JW. The Effect of Triangular Fibrocartilage Complex Tear on Wrist Proprioception. J Hand Surg Am 2018. [PMID: 29523373 DOI: 10.1016/j.jhsa.2018.01.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE This study examined the influence of triangular fibrocartilage complex (TFCC) deep fiber tears on wrist proprioception. METHODS The study involved 48 subjects: 24 with deep fiber TFCC tears and 24 with healthy wrists. A specially created sensor measured wrist proprioception in 3 axes of movement. Absolute differences between target and subject-reproduced angles were compared in injured and healthy wrists and in injured and contralateral patient wrists. A greater difference in reproduced angles was deemed to reflect a lesser ability to approximate a target angle. RESULTS In wrists with TFCC injuries, 40° pronation and 60° pronation showed significantly greater differences between target and subject-reproduced angles compared with those in the control wrists. In wrists with TFCC injuries, 40° pronation demonstrated significantly greater differences between target and subject-reproduced angles than did those in patients' contralateral wrists. Proportions of outliers with absolute differences greater than 6° were significantly higher in 60° supination and 40° pronation in wrists with TFCC injuries. CONCLUSIONS Deep TFCC fiber detachment may lead to decreased wrist proprioception in 60° and 40° forearm rotation. CLINICAL RELEVANCE Deep TFCC fiber tear may contribute to decreased wrist rotational positioning sense and may have biomechanical importance in distal radioulnar joint stability.
Collapse
Affiliation(s)
- Ji Hun Park
- Department of Orthopaedic Surgery, College of Medicine, Korea University, Seoul, Korea
| | - Dongmin Kim
- Department of Orthopaedic Surgery, College of Medicine, Korea University, Seoul, Korea
| | - Heesu Park
- Biomedical Research Institute, Korea Institute of Science and Technology, Seoul, Korea
| | - Inwon Jung
- Biomedical Research Institute, Korea Institute of Science and Technology, Seoul, Korea
| | - Inchan Youn
- Biomedical Research Institute, Korea Institute of Science and Technology, Seoul, Korea
| | - Jong Woong Park
- Department of Orthopaedic Surgery, College of Medicine, Korea University, Seoul, Korea.
| |
Collapse
|
16
|
Abur D, Lester-Smith RA, Daliri A, Lupiani AA, Guenther FH, Stepp CE. Sensorimotor adaptation of voice fundamental frequency in Parkinson's disease. PLoS One 2018; 13:e0191839. [PMID: 29373589 PMCID: PMC5786318 DOI: 10.1371/journal.pone.0191839] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 01/11/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE This study examined adaptive responses to auditory perturbation of fundamental frequency (fo) in speakers with Parkinson's disease (PD) and control speakers. METHOD Sixteen speakers with PD and nineteen control speakers produced sustained vowels while they received perturbed auditory feedback (i.e., fo shifted upward or downward). Speakers' pitch acuity was quantified using a just-noticeable-difference (JND) paradigm. Twelve listeners provided estimates of the speech intelligibility for speakers with PD. RESULTS Fifteen responses from each speaker group for each shift direction were included in analyses. While control speakers generally showed consistent adaptive responses opposing the perturbation, speakers with PD showed no compensation on average, with individual PD speakers showing highly variable responses. In the PD group, the degree of compensation was not significantly correlated with age, disease progression, pitch acuity, or intelligibility. CONCLUSIONS These findings indicate reduced adaptation to sustained fo perturbation and higher variability in PD compared to control participants. No significant differences were seen in pitch acuity between groups, suggesting that the fo adaptation deficit in PD is not the result of purely perceptual mechanisms. SIGNIFICANCE These results suggest there is an impairment in vocal motor control in PD. Building on these results, contributions can be made to developing targeted voice treatments for PD.
Collapse
Affiliation(s)
- Defne Abur
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA, United States of America
| | - Rosemary A. Lester-Smith
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA, United States of America
| | - Ayoub Daliri
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA, United States of America
| | - Ashling A. Lupiani
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA, United States of America
| | - Frank H. Guenther
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA, United States of America
- Department of Biomedical Engineering, Boston University, Boston, MA, United States of America
| | - Cara E. Stepp
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA, United States of America
- Department of Biomedical Engineering, Boston University, Boston, MA, United States of America
- Department of Otolaryngology–Head and Neck Surgery, Boston University School of Medicine, Boston, MA, United States of America
- * E-mail:
| |
Collapse
|
17
|
Kearney E, Shellikeri S, Martino R, Yunusova Y. Augmented visual feedback-aided interventions for motor rehabilitation in Parkinson's disease: a systematic review. Disabil Rehabil 2018; 41:995-1011. [PMID: 29316816 DOI: 10.1080/09638288.2017.1419292] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE A systematic review was performed to (1) evaluate the effectiveness of augmented visual feedback-based treatments for motor rehabilitation in Parkinson's disease, and (2) examine treatment design factors associated with enhanced outcomes following these treatments. METHODS Eight databases were searched from their start-date up to January 2017 using the key terms Parkinson's Disease and augmented visual feedback. Two independent raters screened the abstracts and full articles for inclusion. Relevant data were extracted and summarized, and methodological quality of accepted articles was assessed. RESULTS Eight single-group studies and 10 randomized control trials were included in the review. Augmented visual feedback-based treatments resulted in improved outcomes with small to large effect sizes post-treatment for the majority of impairment, activity, participation, and global motor function measures, and these improvements were often superior to traditional rehabilitation/education programs. Enhanced treatment outcomes were observed in studies that provided large amounts and high intensities of treatment; gamified feedback; and provided knowledge of performance feedback in real-time on 100% of practice trials. CONCLUSION Augmented visual feedback appears to be a useful motor rehabilitation tool in Parkinson's disease; however, high-quality, rigorous studies remain limited. Future studies should consider factors that enhance rehabilitation outcomes when designing augmented visual feedback-based interventions. Implications for rehabilitation Augmented visual feedback is a useful tool for motor rehabilitation in Parkinson's disease; augmented visual feedback-based treatments are often superior to traditional programs. These treatments are associated with improved outcomes in impairment, activity, participation, and global motor function domains. Rehabilitation professionals can optimize their use of augmented visual feedback-based treatments by providing large amounts and a high intensity of treatment, gamifying feedback, and providing knowledge of performance feedback in real-time and at a high frequency.
Collapse
Affiliation(s)
- Elaine Kearney
- a Department of Speech-Language Pathology , University of Toronto , Toronto , Canada.,b Toronto Rehabilitation Institute , University Health Network , Toronto , Canada
| | - Sanjana Shellikeri
- a Department of Speech-Language Pathology , University of Toronto , Toronto , Canada.,c Biological Sciences , Sunnybrook Research Institute , Toronto , Canada
| | - Rosemary Martino
- a Department of Speech-Language Pathology , University of Toronto , Toronto , Canada.,d Division of Healthcare and Outcomes Research , Krembil Research Institute , Toronto , Canada
| | - Yana Yunusova
- a Department of Speech-Language Pathology , University of Toronto , Toronto , Canada.,b Toronto Rehabilitation Institute , University Health Network , Toronto , Canada.,c Biological Sciences , Sunnybrook Research Institute , Toronto , Canada
| |
Collapse
|
18
|
Ribot-Ciscar E, Aimonetti JM, Azulay JP. Sensory training with vibration-induced kinesthetic illusions improves proprioceptive integration in patients with Parkinson's disease. J Neurol Sci 2017; 383:161-165. [PMID: 29246606 DOI: 10.1016/j.jns.2017.11.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 09/21/2017] [Accepted: 11/14/2017] [Indexed: 10/18/2022]
Abstract
The present study investigates whether proprioceptive training, based on kinesthetic illusions, can help in re-educating the processing of muscle proprioceptive input, which is impaired in patients with Parkinson's disease (PD). The processing of proprioceptive input before and after training was evaluated by determining the error in the amplitude of voluntary dorsiflexion ankle movement (20°), induced by applying a vibration on the tendon of the gastrocnemius-soleus muscle (a vibration-induced movement error). The training consisted of the subjects focusing their attention upon a series of illusory movements of the ankle. Eleven PD patients and eleven age-matched control subjects were tested. Before training, vibration reduced dorsiflexion amplitude in controls by 4.3° (P<0.001); conversely, vibration was inefficient in PD's movement amplitude (reduction of 2.1°, P=0.20). After training, vibration significantly reduced the estimated movement amplitude in PD patients by 5.3° (P=0.01). This re-emergence of a vibration-induced error leads us to conclude that proprioceptive training, based on kinesthetic illusions, is a simple means for re-educating the processing of muscle proprioceptive input in PD patients. Such complementary training should be included in rehabilitation programs that presently focus on improving balance and motor performance.
Collapse
Affiliation(s)
| | | | - Jean-Philippe Azulay
- APHM, Hôpital de la Timone, Service de Neurologie et pathologie du Mouvement, 13385 Marseille, France
| |
Collapse
|
19
|
Röijezon U, Faleij R, Karvelis P, Georgoulas G, Nikolakopoulos G. A new clinical test for sensorimotor function of the hand - development and preliminary validation. BMC Musculoskelet Disord 2017; 18:407. [PMID: 28950843 PMCID: PMC5615462 DOI: 10.1186/s12891-017-1764-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 09/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sensorimotor disturbances of the hand such as altered neuromuscular control and reduced proprioception have been reported for various musculoskeletal disorders. This can have major impact on daily activities such as dressing, cooking and manual work, especially when involving high demands on precision and therefore needs to be considered in the assessment and rehabilitation of hand disorders. There is however a lack of feasible and accurate objective methods for the assessment of movement behavior, including proprioception tests, of the hand in the clinic today. The objective of this observational cross- sectional study was to develop and conduct preliminary validation testing of a new method for clinical assessment of movement sense of the wrist using a laser pointer and an automatic scoring system of test results. METHODS Fifty physiotherapists performed a tracking task with a hand-held laser pointer by following a zig-zag pattern as accurately as possible. The task was performed with left and right hand in both left and right directions, with three trials for each hand movement. Each trial was video recorded and analysed with a specifically tailored image processing pipeline for automatic quantification of the test. The main outcome variable was Acuity, calculated as the percent of the time the laser dot was on the target line during the trial. RESULTS The results showed a significantly better Acuity for the dominant compared to non-dominant hand. Participants with right hand pain within the last 12 months had a significantly reduced acuity (p < 0.05), and although not significant there was also a similar trend for reduced Acuity also for participants with left hand pain. Furthermore, there was a clear negative correlation between Acuity and Speed indicating a speed-accuracy trade off commonly found in manual tasks. The repeatability of the test showed acceptable intra class correlation (ICC2.1) values (0.68-0.81) and standard error of measurement values ranging between 5.0-6.3 for Acuity. CONCLUSIONS The initial results suggest that the test may be a valid and feasible test for assessment of the movement sense of the hand. Future research should include assessments on different patient groups and reliability evaluations over time and between testers.
Collapse
Affiliation(s)
- Ulrik Röijezon
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
| | - Ragnar Faleij
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - Petros Karvelis
- Laboratory of Knowledge and Intelligent Computing, Department of Computer Engineering, Technological Educational Institute of Epirus, Arta, Greece
| | - George Georgoulas
- Control Engineering Group Department of Computer Science, Electrical and Space Engineering Luleâ University of Technology, Luleâ, Sweden
| | - George Nikolakopoulos
- Control Engineering Group Department of Computer Science, Electrical and Space Engineering Luleâ University of Technology, Luleâ, Sweden
| |
Collapse
|
20
|
Marini F, Contu S, Antuvan CW, Morasso P, Masia L. The Influence of External Forces on Wrist Proprioception. Front Hum Neurosci 2017; 11:440. [PMID: 28912703 PMCID: PMC5583607 DOI: 10.3389/fnhum.2017.00440] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 08/16/2017] [Indexed: 11/13/2022] Open
Abstract
Proprioception combines information from cutaneous, joint, tendon, and muscle receptors for maintaining a reliable internal body image. However, it is still a matter of debate, in both neurophysiology and psychology, to what extent such body image is modified or distorted by a changing haptic environment. In particular, what is worth investigating is the contribution of external forces on our perception of body and joint configuration. The proprioceptive acuity of fifteen young participants was tested with a Joint Position Matching (JPM) task, performed with the dominant wrist under five different external forces, in order to understand to what extent they affect proprioceptive acuity. Results show that accuracy and precision in target matching do not change in a significant manner as a function of the loading condition, suggesting that the multi-sensory integration process is indeed capable of discriminating different sub-modalities of proprioception, namely the joint position sense and the sense of force. Furthermore, results indicate a preference for target undershooting when movements are performed in a viscous or high resistive force field, rather than passive or null fields in which subjects did not show any predominance for under/over estimation of their position.
Collapse
Affiliation(s)
- Francesca Marini
- Motor Learning and Robotic Rehabilitation Laboratory, Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di TecnologiaGenova, Italy
| | - Sara Contu
- School of Mechanical and Aerospace Engineering, Nanyang Technological UniversitySingapore, Singapore
| | - Chris W Antuvan
- School of Mechanical and Aerospace Engineering, Nanyang Technological UniversitySingapore, Singapore
| | - Pietro Morasso
- Motor Learning and Robotic Rehabilitation Laboratory, Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di TecnologiaGenova, Italy
| | - Lorenzo Masia
- School of Mechanical and Aerospace Engineering, Nanyang Technological UniversitySingapore, Singapore
| |
Collapse
|
21
|
Yunusova Y, Kearney E, Kulkarni M, Haworth B, Baljko M, Faloutsos P. Game-Based Augmented Visual Feedback for Enlarging Speech Movements in Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:1818-1825. [PMID: 28655041 DOI: 10.1044/2017_jslhr-s-16-0233] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 12/08/2016] [Indexed: 06/07/2023]
Abstract
PURPOSE The purpose of this pilot study was to demonstrate the effect of augmented visual feedback on acquisition and short-term retention of a relatively simple instruction to increase movement amplitude during speaking tasks in patients with dysarthria due to Parkinson's disease (PD). METHOD Nine patients diagnosed with PD, hypokinetic dysarthria, and impaired speech intelligibility participated in a training program aimed at increasing the size of their articulatory (tongue) movements during sentences. Two sessions were conducted: a baseline and training session, followed by a retention session 48 hr later. At baseline, sentences were produced at normal, loud, and clear speaking conditions. Game-based visual feedback regarding the size of the articulatory working space (AWS) was presented during training. RESULTS Eight of nine participants benefited from training, increasing their sentence AWS to a greater degree following feedback as compared with the baseline loud and clear conditions. The majority of participants were able to demonstrate the learned skill at the retention session. CONCLUSIONS This study demonstrated the feasibility of augmented visual feedback via articulatory kinematics for training movement enlargement in patients with hypokinesia due to PD. SUPPLEMENTAL MATERIALS https://doi.org/10.23641/asha.5116840.
Collapse
Affiliation(s)
- Yana Yunusova
- Department of Speech-Language Pathology, University of Toronto, Ontario, CanadaSunnybrook Research Institute, Hurvitz Brain Sciences Research Program, Toronto, Ontario, CanadaUniversity Health Network: Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Elaine Kearney
- Department of Speech-Language Pathology, University of Toronto, Ontario, CanadaUniversity Health Network: Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Madhura Kulkarni
- Sunnybrook Research Institute, Hurvitz Brain Sciences Research Program, Toronto, Ontario, CanadaUniversity Health Network: Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Brandon Haworth
- University Health Network: Toronto Rehabilitation Institute, Toronto, Ontario, CanadaDepartment of Electrical Engineering & Computer Science, York University, Toronto, Ontario, Canada
| | - Melanie Baljko
- University Health Network: Toronto Rehabilitation Institute, Toronto, Ontario, CanadaDepartment of Electrical Engineering & Computer Science, York University, Toronto, Ontario, Canada
| | - Petros Faloutsos
- University Health Network: Toronto Rehabilitation Institute, Toronto, Ontario, CanadaDepartment of Electrical Engineering & Computer Science, York University, Toronto, Ontario, Canada
| |
Collapse
|
22
|
Cuppone AV, Squeri V, Semprini M, Masia L, Konczak J. Robot-Assisted Proprioceptive Training with Added Vibro-Tactile Feedback Enhances Somatosensory and Motor Performance. PLoS One 2016; 11:e0164511. [PMID: 27727321 PMCID: PMC5058482 DOI: 10.1371/journal.pone.0164511] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 09/25/2016] [Indexed: 11/19/2022] Open
Abstract
This study examined the trainability of the proprioceptive sense and explored the relationship between proprioception and motor learning. With vision blocked, human learners had to perform goal-directed wrist movements relying solely on proprioceptive/haptic cues to reach several haptically specified targets. One group received additional somatosensory movement error feedback in form of vibro-tactile cues applied to the skin of the forearm. We used a haptic robotic device for the wrist and implemented a 3-day training regimen that required learners to make spatially precise goal-directed wrist reaching movements without vision. We assessed whether training improved the acuity of the wrist joint position sense. In addition, we checked if sensory learning generalized to the motor domain and improved spatial precision of wrist tracking movements that were not trained. The main findings of the study are: First, proprioceptive acuity of the wrist joint position sense improved after training for the group that received the combined proprioceptive/haptic and vibro-tactile feedback (VTF). Second, training had no impact on the spatial accuracy of the untrained tracking task. However, learners who had received VTF significantly reduced their reliance on haptic guidance feedback when performing the untrained motor task. That is, concurrent VTF was highly salient movement feedback and obviated the need for haptic feedback. Third, VTF can be also provided by the limb not involved in the task. Learners who received VTF to the contralateral limb equally benefitted. In conclusion, somatosensory training can significantly enhance proprioceptive acuity within days when learning is coupled with vibro-tactile sensory cues that provide feedback about movement errors. The observable sensory improvements in proprioception facilitates motor learning and such learning may generalize to the sensorimotor control of the untrained motor tasks. The implications of these findings for neurorehabilitation are discussed.
Collapse
Affiliation(s)
- Anna Vera Cuppone
- Motor Learning and Robotic Rehabilitation Laboratory, Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
| | - Valentina Squeri
- Motor Learning and Robotic Rehabilitation Laboratory, Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
| | - Marianna Semprini
- Neural Computation Laboratory, Center for Neuroscience and Cognitive Systems, Istituto Italiano di Tecnologia, Rovereto, Italy
| | - Lorenzo Masia
- School of Mechanical & Aerospace Engineering, Nanyang Technological University, Singapore, Singapore
| | - Jürgen Konczak
- Human Sensorimotor Control Laboratory, School of Kinesiology and Center for Clinical Movement Science, University of Minnesota, Minneapolis, MN, United States of America
| |
Collapse
|
23
|
Hwang S, Agada P, Grill S, Kiemel T, Jeka JJ. A central processing sensory deficit with Parkinson's disease. Exp Brain Res 2016; 234:2369-79. [PMID: 27059036 DOI: 10.1007/s00221-016-4642-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 03/30/2016] [Indexed: 10/22/2022]
Abstract
Parkinson's disease (PD) is a progressive degenerative disease manifested by tremor, rigidity, bradykinesia, and postural instability. Deficits in proprioceptive integration are prevalent in individuals with PD, even at early stages of the disease. These deficits have been demonstrated primarily during investigations of reaching. Here, we investigated how PD affects sensory fusion of multiple modalities during upright standing. We simultaneously perturbed upright stance with visual, vestibular, and proprioceptive stimulation, to understand how these modalities are reweighted so that overall feedback remains suited to stabilizing upright stance in individuals with PD. Eight individuals with PD stood in a visual cave with a moving visual scene at 0.2 Hz while an 80-Hz vibratory stimulus was applied bilaterally to their Achilles tendons (stimulus turns on-off at 0.28 Hz) and a ±1 mA bilateral monopolar galvanic stimulus was applied at 0.36 Hz. The visual stimulus was presented at different amplitudes (0.2°, 0.8° rotation about ankle axis) to measure: the change in gain (weighting) to vision, an intramodal effect; and a simultaneous change in gain to vibration and galvanic stimulation, both intermodal effects. Trunk/leg gain relative to vision decreased when visual amplitude was increased, reflecting an intramodal visual effect. In contrast, when vibration was turned on/off, leg gain relative to vision was equivalent in individuals with PD, indicating no reweighting of visual information when proprioception was disrupted through vibration (i.e., no intermodal effect). Trunk and leg angle gain relative to GVS also showed no reweighting in individuals with PD. These results are in contrast to previous results with healthy adults, who showed clear intermodal effects in the same paradigm, suggesting that individuals with PD not only have a proprioceptive deficit during standing, but also have a cross-modal sensory fusion deficit that is crucial for upright stance control.
Collapse
Affiliation(s)
- Sungjae Hwang
- Department of Kinesiology, Temple University, Philadelphia, PA, 19122, USA.
| | - Peter Agada
- Department of Kinesiology, Temple University, Philadelphia, PA, 19122, USA
| | - Stephen Grill
- Parkinson's & Movement Disorders Center of Maryland, Elkridge, MD, 21075, USA
| | - Tim Kiemel
- Department of Kinesiology, University of Maryland, College Park, MD, 20742, USA
| | - John J Jeka
- Department of Kinesiology, Temple University, Philadelphia, PA, 19122, USA.,Department of Bioengineering, Temple University, Philadelphia, PA, 19122, USA.,Department of Kinesiology, University of Maryland, College Park, MD, 20742, USA
| |
Collapse
|
24
|
Pisa Syndrome in Parkinson's Disease: Electromyographic Aspects and Implications for Rehabilitation. PARKINSONS DISEASE 2015; 2015:437190. [PMID: 26682083 PMCID: PMC4670865 DOI: 10.1155/2015/437190] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 11/09/2015] [Indexed: 11/18/2022]
Abstract
Pisa Syndrome (PS) is a real clinical enigma, and its management remains a challenge. In order to improve the knowledge about resting state and during maximal voluntary muscle contraction (MVMC) of the axial muscles, we described the electromyography results of paraspinal muscles, rectus abdominis, external oblique, and quadratus lumborum of both sides of 60 patients. Electromyography was assessed at rest, during MVMC while bending in the opposite direction of the PS and during MVMC while bending in the direction of the PS. The MVMC gave information about the interferential pattern (INT) or subinterferential pattern (sub-INT). We defined asymmetrical activation (AA) when a sub-INT was detected on the muscle on the side opposite to the PS bending and an INT of same muscle in the direction of PS bending. We observed significant AA during MVMC only in the external oblique muscles in 78% of the subjects. Our results of asymmetric ability to generate maximal voluntary force of the external oblique muscles support a central dissynchronisation of axial muscles as a significant contributor for the bending of the spine in erect position. These results could have important implication to physiotherapy and the use of botulinum toxin in the treatment of PS.
Collapse
|
25
|
Cappello L, Elangovan N, Contu S, Khosravani S, Konczak J, Masia L. Robot-aided assessment of wrist proprioception. Front Hum Neurosci 2015; 9:198. [PMID: 25926785 PMCID: PMC4396514 DOI: 10.3389/fnhum.2015.00198] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 03/25/2015] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Impaired proprioception severely affects the control of gross and fine motor function. However, clinical assessment of proprioceptive deficits and its impact on motor function has been difficult to elucidate. Recent advances in haptic robotic interfaces designed for sensorimotor rehabilitation enabled the use of such devices for the assessment of proprioceptive function. PURPOSE This study evaluated the feasibility of a wrist robot system to determine proprioceptive discrimination thresholds for two different DoFs of the wrist. Specifically, we sought to accomplish three aims: first, to establish data validity; second, to show that the system is sensitive to detect small differences in acuity; third, to establish test-retest reliability over repeated testing. METHODOLOGY Eleven healthy adult subjects experienced two passive wrist movements and had to verbally indicate which movement had the larger amplitude. Based on a subject's response data, a psychometric function was fitted and the wrist acuity threshold was established at the 75% correct response level. A subset of five subjects repeated the experimentation three times (T1, T2, and T3) to determine the test-retest reliability. RESULTS Mean threshold for wrist flexion was 2.15°± 0.43° and 1.52°± 0.36° for abduction. Encoder resolutions were 0.0075°(flexion-extension) and 0.0032°(abduction-adduction). Motor resolutions were 0.2°(flexion-extension) and 0.3°(abduction-adduction). Reliability coefficients were r T2-T1 = 0.986 and r T3-T2 = 0.971. CONCLUSION We currently lack established norm data on the proprioceptive acuity of the wrist to establish direct validity. However, the magnitude of our reported thresholds is physiological, plausible, and well in line with available threshold data obtained at the elbow joint. Moreover, system has high resolution and is sensitive enough to detect small differences in acuity. Finally, the system produces reliable data over repeated testing.
Collapse
Affiliation(s)
- Leonardo Cappello
- Department of Robotics Brain and Cognitive Sciences, Istituto Italiano di Tecnologia , Genova , Italy
| | - Naveen Elangovan
- School of Kinesiology, University of Minnesota , Minneapolis, MN , USA
| | - Sara Contu
- School of Mechanical and Aerospace Engineering, Nanyang Technological University , Singapore , Singapore
| | - Sanaz Khosravani
- School of Kinesiology, University of Minnesota , Minneapolis, MN , USA
| | - Jürgen Konczak
- School of Kinesiology, University of Minnesota , Minneapolis, MN , USA
| | - Lorenzo Masia
- School of Mechanical and Aerospace Engineering, Nanyang Technological University , Singapore , Singapore
| |
Collapse
|
26
|
Aman JE, Elangovan N, Yeh IL, Konczak J. The effectiveness of proprioceptive training for improving motor function: a systematic review. Front Hum Neurosci 2015; 8:1075. [PMID: 25674059 PMCID: PMC4309156 DOI: 10.3389/fnhum.2014.01075] [Citation(s) in RCA: 168] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 12/30/2014] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Numerous reports advocate that training of the proprioceptive sense is a viable behavioral therapy for improving impaired motor function. However, there is little agreement of what constitutes proprioceptive training and how effective it is. We therefore conducted a comprehensive, systematic review of the available literature in order to provide clarity to the notion of training the proprioceptive system. METHODS Four major scientific databases were searched. The following criteria were subsequently applied: (1) A quantified pre- and post-treatment measure of proprioceptive function. (2) An intervention or training program believed to influence or enhance proprioceptive function. (3) Contained at least one form of treatment or outcome measure that is indicative of somatosensory function. From a total of 1284 articles, 51 studies fulfilled all criteria and were selected for further review. RESULTS Overall, proprioceptive training resulted in an average improvement of 52% across all outcome measures. Applying muscle vibration above 30 Hz for longer durations (i.e., min vs. s) induced outcome improvements of up to 60%. Joint position and target reaching training consistently enhanced joint position sense (up to 109%) showing an average improvement of 48%. Cortical stroke was the most studied disease entity but no clear evidence indicated that proprioceptive training is differentially beneficial across the reported diseases. CONCLUSIONS There is converging evidence that proprioceptive training can yield meaningful improvements in somatosensory and sensorimotor function. However, there is a clear need for further work. Those forms of training utilizing both passive and active movements with and without visual feedback tended to be most beneficial. There is also initial evidence suggesting that proprioceptive training induces cortical reorganization, reinforcing the notion that proprioceptive training is a viable method for improving sensorimotor function.
Collapse
Affiliation(s)
- Joshua E Aman
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota Minneapolis, MN, USA ; Center for Clinical Movement Science, University of Minnesota Minneapolis, MN, USA
| | - Naveen Elangovan
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota Minneapolis, MN, USA
| | - I-Ling Yeh
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota Minneapolis, MN, USA
| | - Jürgen Konczak
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota Minneapolis, MN, USA ; Center for Clinical Movement Science, University of Minnesota Minneapolis, MN, USA
| |
Collapse
|
27
|
Melgari JM, Curcio G, Mastrolilli F, Salomone G, Trotta L, Tombini M, di Biase L, Scrascia F, Fini R, Fabrizio E, Rossini PM, Vernieri F. Alpha and beta EEG power reflects L-dopa acute administration in parkinsonian patients. Front Aging Neurosci 2014; 6:302. [PMID: 25452725 PMCID: PMC4233983 DOI: 10.3389/fnagi.2014.00302] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 10/17/2014] [Indexed: 12/05/2022] Open
Abstract
Aim: To evaluate the effect of an acute L-dopa administration on eye-closed resting state electroencephalographic (EEG) activity of cognitively preserved Parkinsonian patients. Methods: We examined 24 right-handed patients diagnosed as uncomplicated probable Parkinson’s disease (PD). Each patient underwent Unified Parkinson’s Disease Rating Scale (UPDRS)-part-III evaluation before and 60 min after an oral load of L-dopa-methyl-ester/carbidopa 250/25 mg. Resting condition eyes-closed EEG data were recorded both pre- and post L-dopa load. Absolute EEG power values were calculated at each scalp derivation for Delta, Theta, Alpha and Beta frequency bands. UPDRS scores (both global and subscale scores) and EEG data (power values of different frequency bands for each scalp derivation) were submitted to a statistical analysis to compare Pre and Post L-Dopa conditions. Finally, a correlation analysis was carried out between EEG spectral content and UPDRS scores. Results: Considering EEG power spectral analysis, no statistically significant differences arose on Delta and Theta bands after L-dopa intake. Conversely, Alpha and Beta rhythms significantly increased on centro-parietal scalp derivations, as a function of L-dopa administration. Correlation analysis indicated a significant negative correlation between Beta power increase on centro-parietal areas and UPDRS subscores (Rigidity of arms and Bradykinesia). A minor significant negative correlation was also found between Alpha band increase and resting tremor. Conclusions: Assuming that a significant change in EEG power spectrum after L-dopa intake may be related to dopaminergic mechanisms, our findings are consistent with the hypothesis that dopaminergic defective networks are implicated in cortical oscillatory abnormalities at rest in non-demented PD patients.
Collapse
Affiliation(s)
| | - Giuseppe Curcio
- Department of Life, Health and Environmental Sciences, University of L'Aquila L'Aquila, Italy ; Casa di Cura S. Raffaele Cassino, Italy
| | | | - Gaetano Salomone
- Department of Neurology, Campus Bio-Medico University Rome, Italy
| | - Laura Trotta
- Department of Neurology, Campus Bio-Medico University Rome, Italy
| | - Mario Tombini
- Department of Neurology, Campus Bio-Medico University Rome, Italy
| | - Lazzaro di Biase
- Department of Neurology, Campus Bio-Medico University Rome, Italy
| | | | - Rita Fini
- Department of Neurology, Campus Bio-Medico University Rome, Italy
| | - Emma Fabrizio
- Department of Neurology, Campus Bio-Medico University Rome, Italy
| | - Paolo Maria Rossini
- Casa di Cura S. Raffaele Cassino, Italy ; Department of Geriatrics, Neuroscience and Orthopedics, Catholic University Rome, Italy
| | | |
Collapse
|
28
|
Subjective visual vertical in Pisa syndrome. Parkinsonism Relat Disord 2014; 20:878-83. [DOI: 10.1016/j.parkreldis.2014.04.030] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 04/21/2014] [Accepted: 04/28/2014] [Indexed: 11/18/2022]
|
29
|
Hammer MJ, Murphy CA, Abrams TM. Airway somatosensory deficits and dysphagia in Parkinson's disease. JOURNAL OF PARKINSONS DISEASE 2014; 3:39-44. [PMID: 23555331 DOI: 10.3233/jpd-120161] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Individuals with Parkinson's disease (PD) often experience substantial impairment of swallow control, and are typically unaware of the presence or severity of their impairments suggesting that these individuals may also experience airway sensory deficits. However, the degree to which impaired swallow function in PD may relate to airway sensory deficits has yet to be formally tested. OBJECTIVE The purpose of this study was to examine whether airway sensory function is associated with swallow impairment in PD. METHODS Eighteen PD participants and 18 healthy controls participated in this study and underwent endoscopic assessment of airway somatosensory function, endoscopic assessment of swallow function, and clinical ratings of swallow and disease severity. RESULTS PD participants exhibited abnormal airway somatosensory function and greater swallow impairment compared with healthy controls. Swallow and sensory deficits in PD were correlated with disease severity. Moreover, PD participants reported similar self-rated swallow function as healthy controls, and swallow deficits were correlated with sensory function suggesting an association between impaired sensory function and poor self-awareness of swallow deficits in PD. CONCLUSIONS These results suggest that control of swallow is influenced by airway somatosensory function, that swallow-related deficits in PD are related to abnormal somatosensation, and that swallow and airway sensory function may degrade as a function of disease severity. Therefore, the basal ganglia and related neural networks may play an important role to integrate airway sensory input for swallow-related motor control. Furthermore, the airway deficits observed in PD suggest a disintegration of swallow-related sensory and motor control.
Collapse
Affiliation(s)
- Michael J Hammer
- Division of Otolaryngology, Department of Surgery, University of Wisconsin, Madison, WI 53792, USA.
| | | | | |
Collapse
|
30
|
Assessing proprioceptive function: evaluating joint position matching methods against psychophysical thresholds. Phys Ther 2014; 94:553-61. [PMID: 24262599 PMCID: PMC6281037 DOI: 10.2522/ptj.20130103] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The importance of assessing proprioceptive function for rehabilitation after neurological or orthopedic injury has long been recognized. Yet, neither the validity nor the accuracy of the available tests is firmly established. Testing typically involves repeated matching of a given joint position with the same or opposite limb where the difference between the 2 positions indicates proprioceptive acuity. OBJECTIVES The aim of this study was to compare position sense acuity between ipsilateral and contralateral matching methods against a psychophysical threshold method to establish the accuracy and relationships between these models. DESIGN A repeated-measures design was used. METHOD Assessment of forearm position sense for a 10-degree reference position in 27 young adults who were healthy. RESULTS Psychophysical thresholds were revealed to be the most precise and least variable acuity measure. The mean (±SD) threshold (1.05°±0.47°) was significantly lower than mean position errors obtained by both joint position matching tasks (ipsilateral: 1.51°±0.64°; contralateral: 1.84°±0.73°)-a 44% to 75% difference in measurement accuracy. Individual participant position errors correlated poorly with respective thresholds, indicating a lack of concurrent validity. Position errors for both matching methods correlated only mildly with each other. LIMITATIONS The data represent performance of a healthy, young adult cohort. Differences between methods will likely be more pronounced in aging and clinical populations. CONCLUSIONS Threshold testing and joint position matching methods examine different physiological aspects of proprioceptive function. Because threshold testing is based on passive motion, it most closely reflects afferent sensory feedback processing (ie, proprioception). Matching methods require active motion and are consequently influenced by additional sensorimotor processes. Factors such as working memory and transmission between brain hemispheres also influence joint matching task outcomes.
Collapse
|
31
|
Aristotle's illusion in Parkinson's disease: evidence for normal interdigit tactile perception. PLoS One 2014; 9:e88686. [PMID: 24523929 PMCID: PMC3921216 DOI: 10.1371/journal.pone.0088686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Accepted: 01/10/2014] [Indexed: 11/27/2022] Open
Abstract
Sensory alterations, a common feature of such movement disorders as Parkinson’s disease (PD) and dystonia, could emerge as epiphenomena of basal ganglia dysfunction. Recently, we found a selective reduction of tactile perception (Aristotle’s illusion, the illusory doubling sensation of one object when touched with crossed fingers) in the affected hand of patients with focal hand dystonia. This suggests that reduced tactile illusion might be a specific feature of this type of dystonia and could be due to abnormal somatosensory cortical activation. The aim of the current study was to investigate whether Aristotle’s illusion is reduced in the affected hand of patients with PD. We tested 15 PD patients, in whom motor symptoms were mainly localised to one side of the body, and 15 healthy controls. Three pairs of fingers were tested in crossed (evoking the illusion) or parallel position (not evoking the illusion). A sphere was placed in the contact point between the two fingers and the blindfolded participants had to say whether they felt one or two stimuli. Stimuli were applied on the affected and less or unaffected side of the PD patients. We found no difference in illusory perception between the PD patients and the controls, nor between the more affected and less/unaffected side, suggesting that Aristotle’s illusion is preserved in PD. The retained tactile illusion in PD and its reduction in focal hand dystonia suggest that the basal ganglia, which are dysfunctional in both PD and dystonia, may not be causally involved in this function. Instead, the level of activation between digits in the somatosensory cortex may be more directly involved. Finally, the similar percentage of illusion in the more affected and less or unaffected body sides indicates that the illusory perception is not influenced by the presence or amount of motor symptoms.
Collapse
|
32
|
Capecci M, Serpicelli C, Fiorentini L, Censi G, Ferretti M, Orni C, Renzi R, Provinciali L, Ceravolo MG. Postural rehabilitation and Kinesio taping for axial postural disorders in Parkinson's disease. Arch Phys Med Rehabil 2014; 95:1067-75. [PMID: 24508531 DOI: 10.1016/j.apmr.2014.01.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 01/02/2014] [Accepted: 01/13/2014] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To assess the effects of postural rehabilitation (PR) on trunk asymmetry and balance, with and without Kinesio taping (KT) of the back muscles as additional treatment, in patients with Parkinson's disease (PD) who have postural disorders. DESIGN Single-blind, randomized controlled trial with 1-month follow-up. SETTING Ambulatory care in referral center. PARTICIPANTS Patients (N=20) with PD showing postural abnormalities of the trunk, in the sagittal and/or coronal plane. INTERVENTIONS Four weeks of patient-tailored proprioceptive and tactile stimulation, combined with stretching and postural reeducation, was provided to 13 subjects (PR group), while 7 received no treatment (control group). Six of the 13 subjects receiving PR also had KT strips applied to their trunk muscles, according to the features of their postural abnormalities. MAIN OUTCOME MEASURES Berg Balance Scale, Timed Up and Go, and degrees of trunk bending in the sagittal and coronal planes were assessed at the enrollment (t0), 1 month later (t1), and 2 months later (t2). RESULTS At t1, all treated patients showed a significant improvement in trunk posture in both the sagittal (P=.002) and coronal planes (P=.01), compared with baseline. Moreover, they showed an improvement in measures of gait and balance (P<.01). Benefits persisted at t2 for all measures, except lateral trunk bend. No differences were found when comparing the PR and KT groups. CONCLUSIONS The combination of active posture correction and trunk movements, muscle stretching, and proprioceptive stimulation may usefully impact PD axial symptoms. Repeated training is advocated to avoid waning of the effect.
Collapse
Affiliation(s)
- Marianna Capecci
- Neurorehabilitation Clinic, Department of Experimental and Clinical Medicine, Clinical Neuroscience Section, Politecnica delle Marche University, Ancona, Italy.
| | - Chiara Serpicelli
- Neurorehabilitation Clinic, Department of Experimental and Clinical Medicine, Clinical Neuroscience Section, Politecnica delle Marche University, Ancona, Italy
| | - Luca Fiorentini
- Neurorehabilitation Clinic, Department of Experimental and Clinical Medicine, Clinical Neuroscience Section, Politecnica delle Marche University, Ancona, Italy
| | - Giovanna Censi
- Neurorehabilitation Clinic, Department of Experimental and Clinical Medicine, Clinical Neuroscience Section, Politecnica delle Marche University, Ancona, Italy
| | - Matteo Ferretti
- Neurorehabilitation Clinic, Department of Experimental and Clinical Medicine, Clinical Neuroscience Section, Politecnica delle Marche University, Ancona, Italy
| | - Chiara Orni
- Neurorehabilitation Clinic, Department of Experimental and Clinical Medicine, Clinical Neuroscience Section, Politecnica delle Marche University, Ancona, Italy
| | - Rosita Renzi
- Neurorehabilitation Clinic, Department of Experimental and Clinical Medicine, Clinical Neuroscience Section, Politecnica delle Marche University, Ancona, Italy
| | - Leandro Provinciali
- Neurologic Clinic, Department of Experimental and Clinical Medicine, Clinical Neuroscience Section, Politecnica delle Marche University, Ancona, Italy
| | - Maria Gabriella Ceravolo
- Neurorehabilitation Clinic, Department of Experimental and Clinical Medicine, Clinical Neuroscience Section, Politecnica delle Marche University, Ancona, Italy
| |
Collapse
|
33
|
Sapir S, Ramig LO, Fox CM. Intensive voice treatment in Parkinson’s disease: Lee Silverman Voice Treatment. Expert Rev Neurother 2014; 11:815-30. [DOI: 10.1586/ern.11.43] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
34
|
Chong RK, Adams K, Fenton K, Gibson M, Hodges K, Horne J, Kirby J, Raisor A, Steiner K, Do MC, Wakade C. Postural adaptation to a slow sensorimotor set-changing task in Parkinson's disease1. ACTA ACUST UNITED AC 2014. [DOI: 10.2466/15.26.cp.3.9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
35
|
Evaluation of a visual biofeedback on the postural control in Parkinson's disease. Neurophysiol Clin 2014; 44:77-86. [DOI: 10.1016/j.neucli.2013.10.134] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 10/16/2013] [Indexed: 11/18/2022] Open
|
36
|
Pasquereau B, Turner RS. Primary motor cortex of the parkinsonian monkey: altered neuronal responses to muscle stretch. Front Syst Neurosci 2013; 7:98. [PMID: 24324412 PMCID: PMC3840326 DOI: 10.3389/fnsys.2013.00098] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 11/11/2013] [Indexed: 11/15/2022] Open
Abstract
Exaggeration of the long-latency stretch reflex (LLSR) is a characteristic neurophysiologic feature of Parkinson's disease (PD) that contributes to parkinsonian rigidity. To explore one frequently-hypothesized mechanism, we studied the effects of fast muscle stretches on neuronal activity in the macaque primary motor cortex (M1) before and after the induction of parkinsonism by unilateral administration of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). We compared results from the general population of M1 neurons and two antidromically-identified subpopulations: distant-projecting pyramidal-tract type neurons (PTNs) and intra-telecenphalic-type corticostriatal neurons (CSNs). Rapid rotations of elbow or wrist joints evoked short-latency responses in 62% of arm-related M1 neurons. As in PD, the late electromyographic responses that constitute the LLSR were enhanced following MPTP. This was accompanied by a shortening of M1 neuronal response latencies and a degradation of directional selectivity, but surprisingly, no increase in single unit response magnitudes. The results suggest that parkinsonism alters the timing and specificity of M1 responses to muscle stretch. Observation of an exaggerated LLSR with no change in the magnitude of proprioceptive responses in M1 is consistent with the idea that the increase in LLSR gain that contributes to parkinsonian rigidity is localized to the spinal cord.
Collapse
Affiliation(s)
- Benjamin Pasquereau
- Department of Neurobiology, Center for Neuroscience and The Center for the Neural Basis of Cognition, University of Pittsburgh Pittsburgh, PA, USA
| | | |
Collapse
|
37
|
LEE D, HENRIQUES DY, SNIDER J, SONG D, POIZNER H. Reaching to proprioceptively defined targets in Parkinson's disease: effects of deep brain stimulation therapy. Neuroscience 2013; 244:99-112. [PMID: 23590906 PMCID: PMC3780593 DOI: 10.1016/j.neuroscience.2013.04.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 04/04/2013] [Accepted: 04/05/2013] [Indexed: 11/26/2022]
Abstract
Deep brain stimulation of the subthalamic nucleus (STN DBS) provides a unique window into human brain function since it can reversibly alter the functioning of specific brain circuits. Basal ganglia-cortical circuits are thought to be excessively noisy in patients with Parkinson's disease (PD), based in part on the lack of specificity of proprioceptive signals in basal ganglia-thalamic-cortical circuits in monkey models of the disease. PD patients are known to have deficits in proprioception, but the effects are often subtle, with paradigms typically restricted to one or two joint movements in a plane. Moreover, the effects of STN DBS on proprioception are virtually unexplored. We tested the following hypotheses: first, that PD patients will show substantial deficits in unconstrained, multi-joint proprioception, and, second, that STN DBS will improve multi-joint proprioception. Twelve PD patients with bilaterally implanted electrodes in the subthalamic nucleus and 12 age-matched healthy subjects were asked to position the left hand at a location that was proprioceptively defined in 3D space with the right hand. In a second condition, subjects were provided visual feedback during the task so that they were not forced to rely on proprioception. Overall, with STN DBS switched off, PD patients showed significantly larger proprioceptive localization errors, and greater variability in endpoint localizations than the control subjects. Visual feedback partially normalized PD performance, and demonstrated that the errors in proprioceptive localization were not simply due to a difficulty in executing the movements or in remembering target locations. Switching STN DBS on significantly reduced localization errors from those of control subjects when patients moved without visual feedback relative to when they moved with visual feedback (when proprioception was not required). However, this reduction in localization errors without vision came at the cost of increased localization variability.
Collapse
Affiliation(s)
- D. LEE
- Institute for Neural Computation, University of California, San Diego, CA, United States
| | - D. Y. HENRIQUES
- School of Kinesiology & Health Science Centre for Vision Research, York University, Toronto, Canada
| | - J. SNIDER
- Institute for Neural Computation, University of California, San Diego, CA, United States
| | - D. SONG
- Department of Neurosciences, University of California, San Diego, CA, United States
| | - H. POIZNER
- Institute for Neural Computation, University of California, San Diego, CA, United States
- Graduate Program in Neurosciences, University of California, San Diego, CA, United States
| |
Collapse
|
38
|
Chen X, Zhu X, Wang EQ, Chen L, Li W, Chen Z, Liu H. Sensorimotor control of vocal pitch production in Parkinson's disease. Brain Res 2013; 1527:99-107. [PMID: 23820424 DOI: 10.1016/j.brainres.2013.06.030] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 06/17/2013] [Accepted: 06/24/2013] [Indexed: 11/26/2022]
|
39
|
Dopaminergic contributions to distance estimation in Parkinson's disease: A sensory-perceptual deficit? Neuropsychologia 2013; 51:1426-34. [DOI: 10.1016/j.neuropsychologia.2013.04.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Revised: 04/17/2013] [Accepted: 04/19/2013] [Indexed: 11/21/2022]
|
40
|
Proske U, Gandevia SC. The proprioceptive senses: their roles in signaling body shape, body position and movement, and muscle force. Physiol Rev 2013; 92:1651-97. [PMID: 23073629 DOI: 10.1152/physrev.00048.2011] [Citation(s) in RCA: 964] [Impact Index Per Article: 87.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
This is a review of the proprioceptive senses generated as a result of our own actions. They include the senses of position and movement of our limbs and trunk, the sense of effort, the sense of force, and the sense of heaviness. Receptors involved in proprioception are located in skin, muscles, and joints. Information about limb position and movement is not generated by individual receptors, but by populations of afferents. Afferent signals generated during a movement are processed to code for endpoint position of a limb. The afferent input is referred to a central body map to determine the location of the limbs in space. Experimental phantom limbs, produced by blocking peripheral nerves, have shown that motor areas in the brain are able to generate conscious sensations of limb displacement and movement in the absence of any sensory input. In the normal limb tendon organs and possibly also muscle spindles contribute to the senses of force and heaviness. Exercise can disturb proprioception, and this has implications for musculoskeletal injuries. Proprioceptive senses, particularly of limb position and movement, deteriorate with age and are associated with an increased risk of falls in the elderly. The more recent information available on proprioception has given a better understanding of the mechanisms underlying these senses as well as providing new insight into a range of clinical conditions.
Collapse
Affiliation(s)
- Uwe Proske
- Department of Physiology, Monash University, Victoria, Australia.
| | | |
Collapse
|
41
|
Lyoo CH, Ryu YH, Lee MJ, Lee MS. Striatal dopamine loss and discriminative sensory dysfunction in Parkinson's disease. Acta Neurol Scand 2012; 126:344-9. [PMID: 22380639 DOI: 10.1111/j.1600-0404.2012.01657.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Patients with Parkinson's disease (PD) have higher-order discriminative sensory dysfunction including prolonged somesthetic temporal discrimination threshold (sTDT). We studied the effect of striatal dopamine loss on the prolongation of sTDT and also studied the impact of prolonged sTDT values on the various parkinsonian motor deficits. MATERIALS AND METHODS In 30 patients with PD, the severity of parkinsonian motor deficits was evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) motor scores during levodopa off and on periods. The UPDRS motor subscores were calculated, representing bradykinesia, rigidity, tremor, and axial motor deficits. During levodopa off and on periods, the sTDT value of each index finger was studied. Using [(18) F]-N-3-fluoropropyl-2-beta-carboxymethoxy-3-beta-(4-iodophenyl) nortropane (FPCIT) positron emission tomography studies, caudate and putaminal dopamine transporter uptake levels were measured. Multiple regression analysis covariated with age was used for statistical analysis. RESULTS During the off period, the striatal FPCIT uptake levels had an impact on the sTDT values (P < 0.01). The sTDT values had an impact on the UPDRS subscores for axial motor deficits (P < 0.05), but had no impact on those for bradykinesia, rigidity, and tremor. The sTDT values as well as UPDRS total motor scores and all UPDRS subscores were improved by a single oral levodopa treatment. CONCLUSIONS Striatal dopamine deficiency and consequent basal ganglia dysfunction may prolong sTDT, and higher-order discriminative sensory dysfunction seems to contribute in part to the development of axial motor deficits in patients with PD.
Collapse
Affiliation(s)
- C. H. Lyoo
- Department of Neurology; Gangnam Severance Hospital; Brain Korea 21 Project for Medical Science; Yonsei University; Seoul; South Korea
| | - Y. H. Ryu
- Department of Nuclear Medicine; Gangnam Severance Hospital; Brain Korea 21 Project for Medical Science; Yonsei University; Seoul; South Korea
| | - M. J. Lee
- Department of Neurology; Gangnam Severance Hospital; Brain Korea 21 Project for Medical Science; Yonsei University; Seoul; South Korea
| | - M. S. Lee
- Department of Neurology; Gangnam Severance Hospital; Brain Korea 21 Project for Medical Science; Yonsei University; Seoul; South Korea
| |
Collapse
|
42
|
Lee PY, Gadareh K, Naushahi MJ, Gresty M, Bronstein AM. Protective stepping response in Parkinsonian patients and the effect of vibrotactile feedback. Mov Disord 2012; 28:482-9. [DOI: 10.1002/mds.25227] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 07/31/2012] [Accepted: 09/06/2012] [Indexed: 12/19/2022] Open
Affiliation(s)
- Pei-Yun Lee
- Neuro-Otology Unit; Division of Experimental Medicine; Imperial College London; Charing Cross Hospital; London United Kingdom
| | - Kris Gadareh
- Neuro-Otology Unit; Division of Experimental Medicine; Imperial College London; Charing Cross Hospital; London United Kingdom
| | - Mohammad J. Naushahi
- Neuromodulation Group; Division of Experimental Medicine; Imperial College London; Charing Cross Hospital; London United Kingdom
| | - Michael Gresty
- Neuro-Otology Unit; Division of Experimental Medicine; Imperial College London; Charing Cross Hospital; London United Kingdom
| | - Adolfo M. Bronstein
- Neuro-Otology Unit; Division of Experimental Medicine; Imperial College London; Charing Cross Hospital; London United Kingdom
| |
Collapse
|
43
|
Speech disorders in Parkinson's disease and the effects of pharmacological, surgical and speech treatment with emphasis on Lee Silverman voice treatment (LSVT(R)). HANDBOOK OF CLINICAL NEUROLOGY 2012. [PMID: 18808924 DOI: 10.1016/s0072-9752(07)83017-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
|
44
|
Degardin A, Devos D, Defebvre L, Destée A, Plomhause L, Derambure P, Devanne H. Effect of intermittent theta-burst stimulation on akinesia and sensorimotor integration in patients with Parkinson’s disease. Eur J Neurosci 2012; 36:2669-78. [DOI: 10.1111/j.1460-9568.2012.08158.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
45
|
Liu H, Wang EQ, Metman LV, Larson CR. Vocal responses to perturbations in voice auditory feedback in individuals with Parkinson's disease. PLoS One 2012; 7:e33629. [PMID: 22448258 PMCID: PMC3308986 DOI: 10.1371/journal.pone.0033629] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 02/16/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND One of the most common symptoms of speech deficits in individuals with Parkinson's disease (PD) is significantly reduced vocal loudness and pitch range. The present study investigated whether abnormal vocalizations in individuals with PD are related to sensory processing of voice auditory feedback. Perturbations in loudness or pitch of voice auditory feedback are known to elicit short latency, compensatory responses in voice amplitude or fundamental frequency. METHODOLOGY/PRINCIPAL FINDINGS Twelve individuals with Parkinson's disease and 13 age- and sex-matched healthy control subjects sustained a vowel sound (/α/) and received unexpected, brief (200 ms) perturbations in voice loudness (±3 or 6 dB) or pitch (±100 cents) auditory feedback. Results showed that, while all subjects produced compensatory responses in their voice amplitude or fundamental frequency, individuals with PD exhibited larger response magnitudes than the control subjects. Furthermore, for loudness-shifted feedback, upward stimuli resulted in shorter response latencies than downward stimuli in the control subjects but not in individuals with PD. CONCLUSIONS/SIGNIFICANCE The larger response magnitudes in individuals with PD compared with the control subjects suggest that processing of voice auditory feedback is abnormal in PD. Although the precise mechanisms of the voice feedback processing are unknown, results of this study suggest that abnormal voice control in individuals with PD may be related to dysfunctional mechanisms of error detection or correction in sensory feedback processing.
Collapse
Affiliation(s)
- Hanjun Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University Guangzhou, People's Republic of China
| | - Emily Q. Wang
- Departments of Communication Disorders and Sciences, and Otolaryngology, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Leo Verhagen Metman
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Charles R. Larson
- Department of Communication Science and Disorders, Northwestern University, Evanston, Illinois, United States of America
- * E-mail:
| |
Collapse
|
46
|
Ramig L, Fox C, Sapir S. Speech and Voice Disorders in Parkinson's Disease. PARKINSON'S DISEASE 2011. [DOI: 10.1002/9781444397970.ch31] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
47
|
Tan T, Almeida QJ, Rahimi F. Proprioceptive deficits in Parkinson's disease patients with freezing of gait. Neuroscience 2011; 192:746-52. [PMID: 21745543 DOI: 10.1016/j.neuroscience.2011.06.071] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 06/22/2011] [Accepted: 06/25/2011] [Indexed: 11/25/2022]
Abstract
Recent research has proposed that proprioceptive deficits may exist in Parkinson's disease (PD); however, proprioception has not been studied in those who experience freezing of gait (FOG). Proprioception was investigated through stimulation of proprioceptive receptors via patellar tendon vibration. In a force matching task to either 10% or 30% maximal voluntary contraction, response to vibration with and without vision of a force target was compared between 15 PD with FOG (PD-FOG), 16 PD without FOG (PD non-FOG), and 15 non-PD control participants (Controls). In a 15-s trial, vision of the target was provided for the first 10 s but in the last 5 s, four conditions were possible: (i) vision, no vibration; (ii) vision, vibration; (iii) no vision, no vibration; or (iv) no vision, vibration. The expected healthy response to vibration was an overshoot of the target. Controls and PD non-FOG did not perform significantly different with or without: vibration or vision. PD-FOG performed similarly to Controls and PD non-FOG in the baseline condition (i). Errors by PD-FOG on the other conditions (ii-iv) were significantly different from the baseline condition but were not significantly different from each other. The PD-FOG group significantly undershot the target when vibration was added [F((2,36))=4.8376, P<0.02] and when vision was removed [F((2,36))=4.8376, P<0.02]. It is suggested that any deviation from normal sensory availability contributes to severe deficits in PD-FOG.
Collapse
Affiliation(s)
- T Tan
- Sun Life Financial Movement Disorders Research & Rehabilitation Centre, Wilfrid Laurier University, 75 University Avenue West, Waterloo, ON, Canada N2L 3C5
| | | | | |
Collapse
|
48
|
Lyoo CH, Ryu YH, Lee MS. Cerebral cortical areas in which thickness correlates with severity of motor deficits of Parkinson's disease. J Neurol 2011; 258:1871-6. [PMID: 21512741 DOI: 10.1007/s00415-011-6045-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 04/03/2011] [Accepted: 04/05/2011] [Indexed: 12/23/2022]
Abstract
The pathology of Parkinson's disease (PD) is not confined to the nigrostriatal dopaminergic pathway, but also involves widespread cerebral cortical areas. Such non-nigrostriatal lesions may contribute to disabling dopa-resistant parkinsonian motor deficits. We performed cortical thickness analysis to identify cerebral cortical brain areas in which thickness correlates with the severity of parkinsonian motor deficits. We performed T1-weighted brain magnetic resonance imaging studies in 142 PD patients. Motor scores on the Unified Parkinson's Disease Rating Scale (UPDRS) were measured, and subscores were calculated for bradykinesia, rigidity, tremor, and axial motor deficits. Using FreeSurfer software, we studied cortical areas in which thickness correlates with disease duration or the severity of parkinsonian motor deficits. The cortical thickness of the parieto-temporal association cortex, including the inferior parietal and posterior parietal cortices, showed a negative correlation with disease duration, total UPDRS motor score, and UPDRS subscores for bradykinesia and axial motor deficits. We found no cortical areas in which thickness correlated with subscores for tremor and rigidity. In addition to nigrostriatal dopaminergic deficit, progressive thinning of the parieto-temporal sensory association cortices related to disease duration seems to be related in part to the exacerbation of bradykinesia and the axial motor symptoms of PD.
Collapse
Affiliation(s)
- Chul Hyoung Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, 712 Eonjuro, Gangnam-gu, Seoul, South Korea.
| | | | | |
Collapse
|
49
|
Vaugoyeau M, Hakam H, Azulay JP. Proprioceptive impairment and postural orientation control in Parkinson’s disease. Hum Mov Sci 2011; 30:405-14. [DOI: 10.1016/j.humov.2010.10.006] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Revised: 09/30/2010] [Accepted: 10/11/2010] [Indexed: 11/28/2022]
|
50
|
Venkatakrishnan A, Banquet JP, Burnod Y, Contreras-vidal JL. Parkinson's disease differentially affects adaptation to gradual as compared to sudden visuomotor distortions. Hum Mov Sci 2011; 30:760-9. [PMID: 21414678 DOI: 10.1016/j.humov.2010.08.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Revised: 08/10/2010] [Accepted: 08/16/2010] [Indexed: 11/18/2022]
Abstract
Patients with Parkinson's disease (PD) have difficulties in movement adaptation to optimize performance in novel environmental contexts such as altered screen cursor-hand relationships. Prior studies have shown that the time course of the distortion differentially affects visuomotor adaptation to screen cursor rotations, suggesting separate mechanisms for gradual and sudden adaptation. Moreover, studies in human and non-human primates suggest that adaptation to sudden kinematic distortions may engage the basal ganglia, whereas adaptation to gradual kinematic distortions involves cerebellar structures. In the present studies, participants were patients with PD, who performed center-out pointing movements, using either a digitizer tablet and pen or a computer trackball, under normal or rotated screen cursor feedback conditions. The initial study tested patients with PD using a cross-over experimental design for adaptation to gradual as compared with sudden rotated hand-screen cursor relationships and revealed significant after-effects for the gradual adaptation task only. Consistent with these results, findings from a follow-up experiment using a trackball that required only small finger movements showed that patients with PD adapt better to gradual as against sudden perturbations, when compared to age-matched healthy controls. We conclude that Parkinson's disease affects adaptation to sudden visuomotor distortions but spares adaptation to gradual distortions.
Collapse
Affiliation(s)
- Anusha Venkatakrishnan
- Graduate Program in Neuroscience & Cognitive Science, Department of Kinesiology, University of Maryland, College Park, College Park, MD 20742, USA.
| | | | | | | |
Collapse
|