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Tardelli E, Moreira-Neto A, Okamoto E, Rogatto F, Vergari-Filho M, Barbosa ER, Silva-Batista C. Telerehabilitation during social distancing for people with Parkinson's disease: a retrospective study. Acta Neurol Belg 2023; 123:1267-1277. [PMID: 36527572 PMCID: PMC9759049 DOI: 10.1007/s13760-022-02160-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION/AIM Clinical worsening has been common in people with Parkinson's disease (PD) during the social distancing due to pandemic. It is unclear if telerehabilitation applied during social distancing preserves clinical aspects of people with PD who are frequent exercisers before the pandemic. Thus, we compared the effects of 10 months of supervised, home-based, real-time videoconferencing telerehabilitation (SRTT) and nonexercising control on clinical aspects in people with PD who are frequent exercisers before the pandemic. METHODS Fifty-seven (SRTT group) and 29 (nonexercising control group) people with PD were retrospectively assessed (Clinical Trials Registry: RBR-54sttfk). Only the SRTT group performed a 60-min online training sessions, 2-3 days per week, for 10 months (April 2020 to January 2021) during social distancing. Quality of life (PD Questionnaire [PDQ-39]), walking (item 28 from the Unified Parkinson's Disease Rating Scale part III [UPDRS-III]), posture (item 29 from the UPDRS-III), and freezing of gait (New-FOG questionnaire [NFOGQ]) were retrospectively assessed before (February-March 2020) and during social distancing (February-March 2021). The assessments were performed in-person and remotely before and during social distancing, respectively. RESULTS There were no between-group differences at baseline (p > 0.05). SRTT preserves PDQ-39 and walking scores but not posture and NFOGQ scores, while nonexercising control worsens scores in all variables. In addition, SRTT is more effective than nonexercising control in preserving PDQ-39 and walking scores. CONCLUSION During social distancing, long-term SRTT preserves the subjective quality of life and walking, but not subjective posture and FOG in people with PD who are frequent exercisers before the pandemic.
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Affiliation(s)
- Erica Tardelli
- Brazil Parkinson Association, São Paulo, Brazil
- Exercise Neuroscience Research Group, University of São Paulo, São Paulo, Brazil
| | - Acácio Moreira-Neto
- Neuroimagem Funcional - Laboratory of Medical Investigations On Magnetic Resonance Imaging, Department of Radiology, University of São Paulo, São Paulo, Brazil
- Exercise Neuroscience Research Group, University of São Paulo, São Paulo, Brazil
| | | | | | - Mario Vergari-Filho
- Neuroimagem Funcional - Laboratory of Medical Investigations On Magnetic Resonance Imaging, Department of Radiology, University of São Paulo, São Paulo, Brazil
- School of Arts, Sciences and Humanities, University of Sao Paulo, São Paulo, SP, Brazil
| | - Egberto Reis Barbosa
- Department of Neurology, Movement Disorders Clinic, School of Medicine of the University of São Paulo, São Paulo, Brazil
| | - Carla Silva-Batista
- Neuroimagem Funcional - Laboratory of Medical Investigations On Magnetic Resonance Imaging, Department of Radiology, University of São Paulo, São Paulo, Brazil.
- Exercise Neuroscience Research Group, University of São Paulo, São Paulo, Brazil.
- School of Arts, Sciences and Humanities, University of Sao Paulo, São Paulo, SP, Brazil.
- Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.
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Buard I, Yang X, Kaizer A, Lattanzio L, Kluger B, Enoka RM. Finger dexterity measured by the Grooved Pegboard test indexes Parkinson's motor severity in a tremor-independent manner. J Electromyogr Kinesiol 2022; 66:102695. [PMID: 36030732 PMCID: PMC9836835 DOI: 10.1016/j.jelekin.2022.102695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 06/24/2022] [Accepted: 08/10/2022] [Indexed: 01/16/2023] Open
Abstract
Fine motor impairments are frequent complaints in people with Parkinson's disease (PD). While they may develop at an early stage of the disease, they become more problematic as the disease progresses. Tremors and fine motor symptoms may seem related, but evidence suggests two distinct phenomena. The purpose of our study was to investigate the relationships between fine motor skills and clinical characteristics of PD patients. We hypothesized worse fine motor skills to be associated with greater motor severity that is independent of tremor. We measured fine motor abilities using the Grooved Pegboard test (GPT) in each hand separately and collected clinical and demographics data in a cohort of 82 persons with PD. We performed regression analyses between GPT scores and a range of outcomes: motor severity, time from diagnosis, age and tremors. We also explored similar associations using finger and hand dexterity scores from a standardized PD rating scale. Our results indicate that scores on the GPT for each hand, as measures of manual dexterity, are associated with motor severity and time from diagnosis. The presence of tremors was not a confounding factor, as hypothesized, but age was associated with GPT scores for the dominant hand. Motor severity was also associated with hand and finger dexterity as measured by single items from the clinical Parkinson's rating scale. These findings suggest that the GPT to be useful tool for motor severity assessments of people with PD.
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Affiliation(s)
- Isabelle Buard
- Department of Neurology, University of Colorado Denver, Aurora, CO, USA.
| | - Xinyi Yang
- Colorado School of Public Health-Biostatistics and Informatics, Aurora, CO, USA
| | - Alexander Kaizer
- Colorado School of Public Health-Biostatistics and Informatics, Aurora, CO, USA
| | - Lucas Lattanzio
- Department of Neurology, University of Colorado Denver, Aurora, CO, USA
| | - Benzi Kluger
- Department of Neurology, University of Rochester Medical Center Rochester, NY, USA
| | - Roger M Enoka
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
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Fathipour-Azar Z, Azad A, Akbarfahimi M, Behzadipour S, Taghizadeh G. Symmetric and asymmetric bimanual coordination and freezing of gait in Parkinsonian patients in drug phases. Ann N Y Acad Sci 2022; 1511:244-261. [PMID: 35194819 DOI: 10.1111/nyas.14759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Indexed: 11/29/2022]
Abstract
Freezing of gait (FOG) is a debilitating symptom in patients with Parkinson's disease (PD), which may be associated with motor control impairments in tasks other than gait. This study aimed to examine whether symmetric and asymmetric bimanual coordination is impaired in PD with FOG (PD +FOG) patients and whether dual-task and drug phases may affect bimanual coordination in these patients. Twenty PD +FOG patients, 20 PD patients without FOG (PD -FOG) performed symmetric and asymmetric functional bimanual tasks (reach to and pick up a box and open a drawer to press a pushbutton inside it, respectively) under single-task and dual-task conditions. PD patients were evaluated during on- and off-drug phases. Kinematic and coordination measures were calculated for each task. PD +FOG patients demonstrated exacerbated impairments of bimanual coordination while performing goal-directed bimanual tasks, which was more evident in the asymmetric bimanual task and under dual-task conditions, highlighting the need for rehabilitation interventions for bimanual tasks that include different cognitive loads in these patients. Interestingly, 25% and 5% of participants in the PD +FOG and -FOG groups developed upper limb freezing 2 years later, respectively. This study aimed to examine whether symmetric and asymmetric bimanual coordination is impaired in Parkinson's disease with freezing of gait (PD +FOG) patients and whether dual-task and drug phases may affect bimanual coordination in these patients. PD +FOG patients demonstrated exacerbated impairment of bimanual coordination while performing goal-directed bimanual tasks, highlighting the need for rehabilitation interventions for bimanual tasks that include different cognitive loads in these patients.
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Affiliation(s)
- Zeinab Fathipour-Azar
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Akram Azad
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Malahat Akbarfahimi
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Behzadipour
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran.,Djavad Mowafaghian Research Center for Intelligent Neuro-rehabilitation Technologies, Tehran, Iran
| | - Ghorban Taghizadeh
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Sombric CJ, Torres-Oviedo G. Cognitive and Motor Perseveration Are Associated in Older Adults. Front Aging Neurosci 2021; 13:610359. [PMID: 33986654 PMCID: PMC8110726 DOI: 10.3389/fnagi.2021.610359] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 03/22/2021] [Indexed: 11/13/2022] Open
Abstract
Aging causes perseveration (difficulty to switch between actions) in motor and cognitive tasks, suggesting that the same neural processes could govern these abilities in older adults. To test this, we evaluated the relation between independently measured motor and cognitive perseveration in young (21.4 ± 3.7 y/o) and older participants (76.5 ± 2.9 y/o). Motor perseveration was measured with a locomotor task in which participants had to transition between distinct walking patterns. Cognitive perseveration was measured with a card matching task in which participants had to switch between distinct matching rules. We found that perseveration in the cognitive and motor domains were positively related in older, but not younger individuals, such that participants exhibiting greater perseveration in the motor task also perseverated more in the cognitive task. Additionally, exposure reduces motor perseveration: older adults who had practiced the motor task could transition between walking patterns as proficiently as naïve, young individuals. Our results suggest an overlap in neural processes governing cognitive and motor perseveration with aging and that exposure can counteract the age-related motor perseveration.
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Affiliation(s)
| | - Gelsy Torres-Oviedo
- Sensorimotor Learning Laboratory, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States
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5
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Dopamine substitution alters effective connectivity of cortical prefrontal, premotor, and motor regions during complex bimanual finger movements in Parkinson's disease. Neuroimage 2019; 190:118-132. [DOI: 10.1016/j.neuroimage.2018.04.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 03/23/2018] [Accepted: 04/12/2018] [Indexed: 01/31/2023] Open
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Sombric CJ, Harker HM, Sparto PJ, Torres-Oviedo G. Explicit Action Switching Interferes with the Context-Specificity of Motor Memories in Older Adults. Front Aging Neurosci 2017; 9:40. [PMID: 28321188 PMCID: PMC5337495 DOI: 10.3389/fnagi.2017.00040] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 02/14/2017] [Indexed: 12/17/2022] Open
Abstract
Healthy aging impairs the ability to adapt movements to novel situations and to switch choices according to the context in cognitive tasks, indicating resistance to changes in motor and cognitive behaviors. Here we examined if this lack of “flexibility” in old subjects observed in motor and cognitive domains were related. To this end, we evaluated subjects' performance in a motor task that required switching walking patterns and its relation to performance in a cognitive switching task. Specifically, a group of old (>73 years old) and young subjects learned a new locomotor pattern on a split-belt treadmill, which drives the legs at different speeds. In both groups, we assessed the ability to disengage the walking pattern learned on the treadmill when walking overground. Then, we determined if this motor context-specificity was related to subjects' cognitive ability to switch actions in a set-shift task. Motor and cognitive behaviors were tested twice on separate visits to determine if age-related differences were maintained with exposure. Consistent with previous studies, we found that old adults adapted slower and had deficits in retention. Most importantly, we found that older subjects could not switch locomotor patterns when transitioning across walking contexts. Interestingly, cognitive switching performance was inversely related to subjects' ability to switch walking patterns. Thus, cognitive mediated switching interfered with locomotor switching. These findings were maintained across testing sessions. Our results suggest that distinct neural substrates mediate motor and cognitive action selection, and that these processes interfere with each other as we age.
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Affiliation(s)
- Carly J Sombric
- Department of Bioengineering, University of Pittsburgh Pittsburgh, PA, USA
| | - Harrison M Harker
- Department of Bioengineering, University of Pittsburgh Pittsburgh, PA, USA
| | - Patrick J Sparto
- Department of Physical Therapy, University of Pittsburgh Pittsburgh, PA, USA
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7
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Subthalamic deep brain stimulation and dopaminergic medication in Parkinson’s disease: Impact on inter-limb coupling. Neuroscience 2016; 335:9-19. [DOI: 10.1016/j.neuroscience.2016.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 08/01/2016] [Accepted: 08/02/2016] [Indexed: 11/24/2022]
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8
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Latash ML, Huang X. Neural control of movement stability: Lessons from studies of neurological patients. Neuroscience 2015; 301:39-48. [PMID: 26047732 DOI: 10.1016/j.neuroscience.2015.05.075] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 05/26/2015] [Accepted: 05/28/2015] [Indexed: 10/23/2022]
Abstract
The concept of synergy provides a theoretical framework for movement stability resulting from the neural organization of multiple elements (digits, muscles, etc.) that all contribute to salient performance variables. Although stability of performance is obviously important for steady-state tasks leading to high synergy indices, a feed-forward drop in synergy indices is seen in preparation to a quick action (i.e., anticipatory synergy adjustments, ASAs). We review recent studies of multi-finger and multi-muscle synergies that show decreased indices of synergies and ASAs in patients with Parkinson's disease (PD) or multisystem atrophy. In PD, the impairments in synergies and ASAs are partially reversed by dopaminergic drugs, and changes in synergy indices are present even in PD patients at earliest diagnosis. Taken together, these results point at subcortical structures that are crucial for proper control of movement stability. It is timely to introduce the concept of impaired control of stability as an objective, quantifiable, and theory-based clinical descriptor of movement disorders that can increase our understanding of the neural control of movement with all of its implications for clinical practice.
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Affiliation(s)
- M L Latash
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA.
| | - X Huang
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA; Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA; Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA; Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA; Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA
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9
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Daneault JF, Carignan B, Sadikot AF, Duval C. Inter-limb coupling during diadochokinesis in Parkinson's and Huntington's disease. Neurosci Res 2015; 97:60-8. [PMID: 25747139 DOI: 10.1016/j.neures.2015.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 01/21/2015] [Accepted: 02/27/2015] [Indexed: 11/16/2022]
Abstract
Patients with neurodegenerative diseases often exhibit deficits in bimanual coordination. One characteristic of bimanual movements is inter-limb coupling. It is the property of motor performance harmonization between hands during a bimanual task. The objective of this study was to identify whether spatial and temporal inter-limb coupling occurred in Parkinson's disease (PD) and Huntington's disease (HD) patients. Twenty-three PD patients and 15 healthy controls were tested. Data from 12 choreic HD patients were also taken from a databank. Participants were asked to perform a unimanual and bimanual rapid repetitive diadochokinesis task. The difference between hands in mean amplitude and mean duration of cycles was computed in the unimanual and bimanual tasks for each group. Results show that healthy controls exhibited temporal and spatial inter-limb coupling during the bimanual diadochokinesis task. Conversely, PD and HD patients exhibited temporal inter-limb coupling; but failed to exhibit spatial inter-limb coupling during the bimanual diadochokinesis task. Furthermore, HD patients exhibited reduced levels of structural coupling compared to controls and PD patients. These results suggest that alterations in basal ganglia-thalamo-cortical networks due to PD and HD do not affect temporal inter-limb coupling. However, common pathophysiological changes related to PD and HD may cause altered spatial inter-limb coupling during a rapid repetitive bimanual diadochokinesis task.
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Affiliation(s)
- Jean-François Daneault
- Cone Laboratory for Research in Neurosurgery, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Benoit Carignan
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Département de Sciences Biologiques, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Abbas F Sadikot
- Cone Laboratory for Research in Neurosurgery, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Christian Duval
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Département des sciences de l'activité physique, Université du Québec à Montréal, Montréal, Québec, Canada.
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Smulders K, Esselink RA, Bloem BR, Cools R. Freezing of gait in Parkinson's disease is related to impaired motor switching during stepping. Mov Disord 2015; 30:1090-7. [DOI: 10.1002/mds.26133] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 11/07/2014] [Accepted: 11/26/2014] [Indexed: 11/10/2022] Open
Affiliation(s)
- Katrijn Smulders
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour; Department of Neurology; 6500 HB Nijmegen The Netherlands
- HAN University of Applied Sciences; Institute for Studies in Sports and Exercise; 6503 GL Nijmegen The Netherlands
| | - Rianne A. Esselink
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour; Department of Neurology; 6500 HB Nijmegen The Netherlands
| | - Bastiaan R. Bloem
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour; Department of Neurology; 6500 HB Nijmegen The Netherlands
| | - Roshan Cools
- Radboud University Medical Center; Donders Institute for Brain, Cognition and Behaviour; Department of Psychiatry; 6500 HB Nijmegen The Netherlands
- Radboud University; Donders Institute for Brain, Cognition and Behaviour; Centre for Cognitive Neuroimaging; 6500 HB Nijmegen The Netherlands
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Jo HJ, Park J, Lewis MM, Huang X, Latash ML. Prehension synergies and hand function in early-stage Parkinson's disease. Exp Brain Res 2014; 233:425-40. [PMID: 25370346 DOI: 10.1007/s00221-014-4130-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 10/09/2014] [Indexed: 11/28/2022]
Abstract
We explored the multi-digit synergies and hand performance in object manipulations and pressing tasks in patients with early-stage Parkinson's disease (PD) and healthy controls. Synergies were defined as inter-trials co-variation patterns among forces/moments produced by individual digits that stabilized a resultant mechanical variable. The subjects performed three main tasks: pressing (steady-state force production followed by a force pulse into the target), prehension (manipulation of a handheld instrumented handle imitating the action of taking a sip from a glass), and functional object manipulation (moving a glass with water as quickly and accurately as possible along a chain of targets). The PD patients were slower compared to controls in all three tasks. Patients showed smaller synergy indices in the pressing and prehension tasks. In the prehension tasks, patients showed elevated grip force at steady states with smaller grip force modulation during the handle motion. PD patients showed smaller feed-forward synergy adjustments in preparation to the quick action in the pressing and (to a smaller degree) prehension tasks. Synergy indices correlated with the time index of performance in the functional glass-with-water task, whereas none of the indices correlated with the Unified PD Rating Scale part III-motor scores. We interpret the results as pointing at an important role of subcortical structures in motor synergies and their feed-forward adjustments to action.
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Affiliation(s)
- Hang Jin Jo
- Department of Kinesiology, The Pennsylvania State University, Rec.Hall-268N, University Park, PA, 16802, USA
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Brown MJN, Almeida QJ, Rahimi F. The dopaminergic system in upper limb motor blocks (ULMB) investigated during bimanual coordination in Parkinson's disease (PD). J Neurol 2014; 262:41-53. [PMID: 25280861 DOI: 10.1007/s00415-014-7514-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 09/12/2014] [Accepted: 09/19/2014] [Indexed: 01/27/2023]
Abstract
Upper limb motor blocks (ULMB) (inability to initiate or sudden discontinue in voluntary movements) have been identified in both unimanual and bimanual tasks in individuals with Parkinson's disease (PD). In particular, ULMB have been observed during rhythmic bimanual coordination when switching between phase patterns which is required (e.g. between in-phase and anti-phase). While sensory-perceptual mechanisms have recently been suggested to be involved in lower limb freezing, there has been no consensus on the mechanism that evokes ULMB or whether motor blocks respond to dopamine replacement like other motor symptoms of PD. The current study investigated the occurrence of ULMB in PD participants without ('off') and with ('on') dopamine replacement using bimanual wrist flexion-extension with external auditory cues. In Experiment 1, coordination was performed in either in-phase (simultaneous flexion and extension) or anti-phase (asymmetrical flexion and extension between the limbs) in one of three sensory conditions: no vision, normal vision or augmented vision. Cycle frequency was increased within each trial across seven cycle frequencies (0.75-2 Hz). In Experiment 2, coordination was initiated in either phase pattern and participants were cued to make an intentional switch between phases in the middle of trials. Trials were performed at one of two cycle frequencies (1 or 2 Hz) and one of two sensory conditions: no vision or normal vision. Healthy age-matched control participants were also investigated in both experiments for the occurrence of motor blocks that were measured using automated detection from a computer algorithm. The results from Experiment 1 indicated that increasing cycle frequency resulted in more ULMB in individuals with PD during continuous coordinated movement, regardless of dopaminergic status, phase pattern or sensory condition. Experiment 2 also confirmed an increased occurrence of ULMB with increased cycle frequency. Furthermore, a large amount of ULMB were observed when initiating anti-phase coordination at 2 Hz, as well as after both externally-cued switches and in 'catch trials' with distracting auditory cues when no switch was required. Dopamine replacement was not found to influence the frequency of ULMB in either experiment. Therefore, ULMB likely result from non-hypodopaminergic impairments associated with PD. Specifically, ULMB may be caused by an inability to shift attentional control under increased cognitive demand that could be associated with hypoactivation in motor and prefrontal areas.
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Affiliation(s)
- Matt J N Brown
- Sun Life Financial Movement Disorders Research and Rehabilitation Centre (MDRC), Wilfrid Laurier University, 75 University Avenue West, Waterloo, ON, N2L 3C5, Canada
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Park J, Jo HJ, Lewis MM, Huang X, Latash ML. Effects of Parkinson's disease on optimization and structure of variance in multi-finger tasks. Exp Brain Res 2013; 231:51-63. [PMID: 23942616 DOI: 10.1007/s00221-013-3665-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 07/29/2013] [Indexed: 10/26/2022]
Abstract
We explored the role of the basal ganglia in two components of multi-finger synergies by testing a group of patients with early-stage Parkinson's disease and a group of healthy controls. Synergies were defined as co-varied adjustments of commands to individual fingers that reduced variance of the total force and moment of force. The framework of the uncontrolled manifold hypothesis was used to quantify such co-variation patterns, while average performance across repetitive trials (sharing patterns) was analyzed using the analytical inverse optimization (ANIO) approach. The subjects performed four-finger pressing tasks that involved the accurate production of combinations of the total force and total moment of force and also repetitive trials at two selected combinations of the total force and moment. The ANIO approach revealed significantly larger deviations of the experimental data planes from an optimal plane for the patients compared to the control subjects. The synergy indices computed for total force stabilization were significantly higher in the control subjects compared to the patients; this was not true for synergy indices computed for moment of force stabilization. The differences in the synergy indices were due to the larger amount of variance that affected total force in the patients, while the amount of variance that did not affect total force was comparable between the groups. We conclude that the basal ganglia play an important role in both components of synergies reflecting optimization of the sharing patterns and stability of performance with respect to functionally important variables.
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Affiliation(s)
- Jaebum Park
- Department of Kinesiology, Rec.Hall-268N, The Pennsylvania State University, University Park, PA, 16802, USA
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Almeida QJ, Brown MJN. Is DOPA-Responsive Hypokinesia Responsible for Bimanual Coordination Deficits in Parkinson's Disease? Front Neurol 2013; 4:89. [PMID: 23882254 PMCID: PMC3715734 DOI: 10.3389/fneur.2013.00089] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Accepted: 06/25/2013] [Indexed: 11/21/2022] Open
Abstract
Bradykinesia is a well-documented DOPA-responsive clinical feature of Parkinson’s disease (PD). While amplitude deficits (hypokinesia) are a key component of this slowness, it is important to consider how dopamine influences both the amplitude (hypokinesia) and frequency components of bradykinesia when a bimanually coordinated movement is required. Based on the notion that the basal ganglia are associated with sensory deficits, the influence of dopaminergic replacement on sensory feedback conditions during bimanual coordination was also evaluated. Bimanual movements were examined in PD and healthy comparisons in an unconstrained three-dimensional coordination task. PD were tested “off” (overnight withdrawal of dopaminergic treatment) and “on” (peak dose of dopaminergic treatment), while the healthy group was evaluated for practice effects across two sessions. Required cycle frequency (increased within each trial from 0.75 to 2 Hz), type of visual feedback (no vision, normal vision, and augmented vision), and coordination pattern (symmetrical in-phase and non-symmetrical anti-phase) were all manipulated. Overall, coordination (mean accuracy and standard deviation of relative phase) and amplitude deficits during bimanual coordination were confirmed in PD participants. In addition, significant correlations were identified between severity of motor symptoms as well as bradykinesia to greater coordination deficits (accuracy and stability) in PD “off” group. However, even though amplitude deficits (hypokinesia) improved with dopaminergic replacement, it did not improve bimanual coordination performance (accuracy or stability) in PD patients from “off” to “on.” Interestingly, while coordination performance in both groups suffered in the augmented vision condition, the amplitude of the more affected limb of PD was notably influenced. It can be concluded that DOPA-responsive hypokinesia contributes to, but is not directly responsible for bimanual coordination impairments in PD. It is likely that bimanual coordination deficits in PD are caused by the combination of dopaminergic system dysfunction as well as other neural impairments that may be DOPA-resistant or related to non-dopaminergic pathways.
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Affiliation(s)
- Quincy J Almeida
- Sun Life Financial Movement Disorders Research and Rehabilitation Centre (MDRC), Wilfrid Laurier University , Waterloo, ON , Canada
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Vercruysse S, Devos H, Munks L, Spildooren J, Vandenbossche J, Vandenberghe W, Nieuwboer A, Heremans E. Explaining freezing of gait in Parkinson's disease: Motor and cognitive determinants. Mov Disord 2012; 27:1644-51. [DOI: 10.1002/mds.25183] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 08/02/2012] [Accepted: 08/08/2012] [Indexed: 11/07/2022] Open
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Park J, Wu YH, Lewis MM, Huang X, Latash ML. Changes in multifinger interaction and coordination in Parkinson's disease. J Neurophysiol 2012; 108:915-24. [PMID: 22552184 DOI: 10.1152/jn.00043.2012] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
In this study, we tested several hypotheses related to changes in finger interaction and multifinger synergies during multifinger force production tasks in Parkinson's disease. Ten patients with Parkinson's disease, mostly early stage, and 11 healthy control subjects participated in the study. Synergies were defined as covaried adjustment of commands to fingers that stabilized the total force produced by the hand. Both Parkinson's disease patients and control subjects performed accurate isometric force production tasks with the fingers of both the dominant and nondominant hands. The Parkinson's disease patients showed significantly lower maximal finger forces and higher unintended force production (enslaving). These observations suggest that changes in supraspinal control have a major effect on finger individuation. The synergy indexes in the patients were weaker in both steady-state and cyclic force production tasks compared with the controls. These indexes also were stronger in the left (nondominant) hand in support of the dynamic-dominance hypothesis. Half of the patients could not perform the cyclic task at the highest frequency (2 Hz). Anticipatory adjustments of synergies prior to a quick force pulse production were delayed and reduced in the patients compared with the controls. Similar differences were observed between the asymptomatic hands of the patients with symptoms limited to one side of the body and matched hands of control subjects. Our study demonstrates that the elusive changes in motor coordination in Parkinson's disease can be quantified objectively, even in patients at a relatively early stage of the disease. The results suggest an important role of the basal ganglia in synergy formation and demonstrate a previously unknown component of impaired feedforward control in Parkinson's disease reflected in the reduced and delayed anticipatory synergy adjustments.
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Affiliation(s)
- Jaebum Park
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania 16802, USA
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