Azulay J P, Mesure S, Amblard B, Blin O, Sangla I, Pouget J
UPR Neurobiologie et Mouvement, CNRS, Department of Neurology, University Hospital La Timone, Marseille, France.
Brain. 1999 Jan;122 ( Pt 1):111-20. doi: 10.1093/brain/122.1.111.
The effect of placing parallel lines on the walking surface on parkinsonian gait was evaluated. To identify the kind of visual cues (static or dynamic) required for the control of locomotion, we tested two visual conditions: normal lighting and stroboscopic illumination (three flashes/s), the latter acting to suppress dynamic visual cues completely. Sixteen subjects with idiopathic Parkinson's disease (nine males, seven females; mean age 68.8 years) and the same number of age-matched controls (seven males; nine females, mean age 67.5 years) were studied. During the baseline phase, Parkinson's disease patients walked with a short-stepped, slow velocity pattern. The double limb support duration was increased and the step cadence was reduced relative to normal. Under normal lighting, visual cues from the lines on the walking surface induced a significant improvement in gait velocity and stride length in Parkinson's disease patients. With stroboscopic illumination and without lines, both groups reduced their stride length and velocity but the changes were significant only in the Parkinson's disease group, indicating greater dependence on dynamic visual information. When stroboscopic light was used with stripes on the floor, the improvement in gait due to the stripes was suppressed in parkinsonian patients. These results demonstrate that the perceived motion of stripes, induced by the patient's walking, is essential to improve the gait parameters and thus favour the hypothesis of a specific visual-motor pathway which is particularly responsive to rapidly moving targets. Previous studies have proposed a cerebellar circuit, allowing the visual stimuli to by-pass the damaged basal ganglia.
评估了在行走表面放置平行线对帕金森步态的影响。为了确定控制运动所需的视觉线索类型（静态或动态），我们测试了两种视觉条件：正常照明和频闪照明（每秒三次闪光），后者可完全抑制动态视觉线索。研究了16名特发性帕金森病患者（9名男性，7名女性；平均年龄68.8岁）以及相同数量的年龄匹配对照组（7名男性，9名女性；平均年龄67.5岁）。在基线阶段，帕金森病患者以小步幅、慢速度的模式行走。与正常人相比，双下肢支撑时间增加，步频降低。在正常照明下，行走表面线条的视觉线索使帕金森病患者的步态速度和步幅有显著改善。在频闪照明且没有线条的情况下，两组的步幅和速度都降低了，但仅在帕金森病组中变化显著，这表明帕金森病组对动态视觉信息的依赖性更强。当在地板上有条纹的情况下使用频闪灯时，帕金森病患者因条纹而改善的步态受到抑制。这些结果表明，患者行走所引发的条纹的感知运动对于改善步态参数至关重要，因此支持了存在一条对快速移动目标特别敏感的特定视觉运动通路这一假说。先前的研究提出了一种小脑回路，使视觉刺激能够绕过受损的基底神经节。
