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帕金森病患者在全手抓握过程中对力分配模式的预期控制受损。

Impaired anticipatory control of force sharing patterns during whole-hand grasping in Parkinson's disease.

作者信息

Muratori Lisa M, McIsaac Tara L, Gordon Andrew M, Santello Marco

机构信息

Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 West 120th Street, New York, NY 10027, USA.

出版信息

Exp Brain Res. 2008 Feb;185(1):41-52. doi: 10.1007/s00221-007-1129-3. Epub 2007 Oct 2.

Abstract

We examined the coordination of multi-digit grasping forces as they developed during object grasping and lifting. Ten subjects with Parkinson's disease (PD; OFF and ON medication) and ten healthy age-matched control subjects lifted a manipulandum that measured normal forces at each digit and the manipulandum's position. The center of mass (CM) was changed from trial to trial in either a predictable (blocked) or unpredictable (random) order. All subjects modulated individual fingertip forces to counterbalance forces exerted by the thumb and minimize object tilt after lift-off. However, subjects with PD OFF exhibited an impaired ability to use anticipatory mechanisms resulting in less differentiated scaling of individual finger forces to the object CM location. Remarkably, these between-group differences in force modulation dissipated as subjects reached peak grip forces during object lift, although these occurred significantly later in subjects with PD OFF than controls and PD ON. Analysis of the tilt of the object during lift revealed all subjects had similar deviations of the object from the vertical, the direction of which depended on CM location. Thus these findings in subjects with PD indicate that: (a) PD-induced impairments in anticipatory force mechanisms appear to be greatly increased in multi-digit grasping as opposed to previous reports from two-digit grasping; (b) inaccurate scaling of fingertip force amplitude and sharing patterns before object lift is recovered during object lift; (c) the implementation of appropriate force amplitude and sharing among the digits during the lift occurs significantly later than for controls; (d) medication improves the temporal recovery of multi-digit force coordination. These results are discussed within the framework of PD-related deficits in sensorimotor integration and control of multi-degrees of freedom movement.

摘要

我们研究了在物体抓取和提起过程中多手指抓握力的协调情况。十名帕金森病(PD;未服药和服药状态)患者以及十名年龄匹配的健康对照者提起一个可测量每个手指的正常力以及该操作对象位置的操作手柄。每次试验中,质心(CM)以可预测(分组)或不可预测(随机)的顺序改变。所有受试者均调节单个指尖力,以抵消拇指施加的力,并在提起后尽量减少物体倾斜。然而,未服药的PD患者运用预期机制的能力受损,导致单个手指力与物体质心位置的比例缩放差异较小。值得注意的是,尽管未服药的PD患者达到峰值握力的时间明显晚于对照组和服药的PD患者,但在物体提起过程中,随着受试者达到峰值握力,这些组间在力调节方面的差异逐渐消失。对物体提起过程中的倾斜分析表明,所有受试者的物体与垂直方向的偏差相似,其方向取决于质心位置。因此,这些在PD患者中的发现表明:(a)与先前关于双指抓握的报告相比,PD引起的预期力机制损伤在多手指抓握中似乎大大增加;(b)在物体提起过程中,物体提起前指尖力幅度和分配模式的不准确缩放得以恢复;(c)提起过程中各手指间适当的力幅度和分配的实施明显晚于对照组;(d)药物治疗可改善多手指力协调的时间恢复。我们在PD相关的感觉运动整合缺陷和多自由度运动控制的框架内讨论了这些结果。

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