Suppr超能文献

帕金森病中的虚拟诱导威胁:行走时焦虑与感觉-知觉加工之间的多巴胺能相互作用

Virtually-induced threat in Parkinson's: Dopaminergic interactions between anxiety and sensory-perceptual processing while walking.

作者信息

Ehgoetz Martens Kaylena A, Ellard Colin G, Almeida Quincy J

机构信息

Sun Life Financial Movement Disorders Research and Rehabilitation Centre, Wilfrid Laurier University, Ontario, Canada; Cognitive Neuroscience, Department of Psychology, University of Waterloo, Ontario, Canada.

Cognitive Neuroscience, Department of Psychology, University of Waterloo, Ontario, Canada.

出版信息

Neuropsychologia. 2015 Dec;79(Pt B):322-31. doi: 10.1016/j.neuropsychologia.2015.05.015. Epub 2015 May 21.

Abstract

Research evidence has suggested that anxiety influences gait in PD, with an identified dopa-sensitive gait response in highly anxious PD. It has been well-established that accurate perception of the environment and sensory feedback is essential for gait. Arguably since sensory and perceptual deficits have been noted in PD, anxiety has the potential to exacerbate movement impairments, since one might expect that reducing resources needed to overcome or compensate for sensory-perceptual deficits may lead to even more severe gait impairments. It is possible that anxiety in threatening situations might consume more processing resources, limiting the ability to process information about the environment or one's own movement (sensory feedback) especially in highly anxious PD. Therefore, the current study aimed to (i) evaluate whether processing of threat-related aspects of the environment was influenced by anxiety, (ii) evaluate whether anxiety influences the ability to utilize sensory feedback in PD while walking in threatening situations, and (iii) further understand the role of dopaminergic medication on these processes in threatening situations in PD. Forty-eight participants (24 HC; 12 Low Anxious [LA-PD], 12 Highly Anxious [HA-PD]) completed 20 walking trials in virtual reality across a plank that was (i) located on the ground (GROUND) (ii) located above a deep pit (ELEVATED); while provided with or without visual feedback about their lower limbs (+VF; -VF). After walking across the plank, participants were asked to judge the width of the plank they had just walked across. The plank varied in size from 60-100 cm. Both ON and OFF dopaminergic medication states were evaluated in PD. Gait parameters, judgment error and self-reported anxiety levels were measured. Results showed that HA-PD reported greater levels of anxiety overall (p<0.001) compared to HC and LA-PD, and all participants reported greater anxiety during the ELEVATED condition compared to GROUND (p=0.01). PD had similar judgment error as HC. Additionally, medication state did not significantly influence judgment error in PD. More importantly, HA-PD were the only group that did not adjust their step width when feedback was provided during the GROUND condition. However, medication facilitated a reduction in ST-CV when visual feedback was available only in the HA-PD group. Therefore, the current study provides evidence that anxiety may interfere with information processing, especially utilizing sensory feedback while walking. Dopaminergic medication appears to improve utilization of sensory feedback in stressful situations by reducing anxiety and/or improving resource allocation especially in those with PD who are highly anxious.

摘要

研究证据表明,焦虑会影响帕金森病(PD)患者的步态,在高度焦虑的PD患者中存在一种已确定的对多巴敏感的步态反应。众所周知,对环境的准确感知和感觉反馈对于步态至关重要。可以说,由于在PD中已注意到感觉和感知缺陷,焦虑有可能加剧运动障碍,因为人们可能预期减少克服或补偿感觉-感知缺陷所需的资源可能会导致更严重的步态障碍。在威胁情境中的焦虑可能会消耗更多的处理资源,限制处理有关环境或自身运动(感觉反馈)信息的能力,尤其是在高度焦虑的PD患者中。因此,本研究旨在:(i)评估环境中与威胁相关方面的处理是否受焦虑影响;(ii)评估焦虑在威胁情境中行走时是否会影响PD患者利用感觉反馈的能力;(iii)进一步了解多巴胺能药物在PD患者威胁情境中的这些过程中所起的作用。48名参与者(24名健康对照者;12名低焦虑[LA-PD]患者,12名高焦虑[HA-PD]患者)在虚拟现实中完成了20次在木板上行走的试验,木板(i)位于地面(GROUND);(ii)位于深坑上方(ELEVATED);同时提供或不提供关于其下肢的视觉反馈(+VF;-VF)。在走过木板后,要求参与者判断他们刚刚走过的木板的宽度。木板大小从60 - 100厘米不等。对PD患者评估了多巴胺能药物开启和关闭两种状态。测量了步态参数、判断误差和自我报告的焦虑水平。结果显示,与健康对照者和LA-PD患者相比,HA-PD患者总体焦虑水平更高(p<0.001),并且与GROUND条件相比,所有参与者在ELEVATED条件下报告的焦虑程度更高(p = 0.01)。PD患者的判断误差与健康对照者相似。此外,药物状态对PD患者的判断误差没有显著影响。更重要的是,HA-PD患者是唯一在GROUND条件下提供反馈时不调整步幅的组。然而,仅在HA-PD组中,当有视觉反馈时药物有助于减少步幅时间-速度变异性(ST-CV)。因此,本研究提供了证据表明焦虑可能会干扰信息处理,尤其是在行走时利用感觉反馈。多巴胺能药物似乎通过减轻焦虑和/或改善资源分配,特别是在高度焦虑的PD患者中,提高了在压力情境下对感觉反馈的利用。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验