Cochen De Cock V, Dotov D G, Ihalainen P, Bégel V, Galtier F, Lebrun C, Picot M C, Driss V, Landragin N, Geny C, Bardy B, Dalla Bella S
Department of Neurology, Beau Soleil Clinic, Montpellier, France.
Clinical Investigation Centre (CIC), 1411, University hospital of Montpellier and Inserm, Montpellier, France.
NPJ Parkinsons Dis. 2018 Mar 23;4:8. doi: 10.1038/s41531-018-0043-7. eCollection 2018.
Rhythmic auditory cues can immediately improve gait in Parkinson's disease. However, this effect varies considerably across patients. The factors associated with this individual variability are not known to date. Patients' rhythmic abilities and musicality (e.g., perceptual and singing abilities, emotional response to music, and musical training) may foster a positive response to rhythmic cues. To examine this hypothesis, we measured gait at baseline and with rhythmic cues in 39 non-demented patients with Parkinson's disease and 39 matched healthy controls. Cognition, rhythmic abilities and general musicality were assessed. A response to cueing was qualified as positive when the stimulation led to a clinically meaningful increase in gait speed. We observed that patients with positive response to cueing ( = 17) were more musically trained, aligned more often their steps to the rhythmic cues while walking, and showed better music perception as well as poorer cognitive flexibility than patients with non-positive response ( = 22). Gait performance with rhythmic cues worsened in six patients. We concluded that rhythmic and musical skills, which can be modulated by musical training, may increase beneficial effects of rhythmic auditory cueing in Parkinson's disease. Screening patients in terms of musical/rhythmic abilities and musical training may allow teasing apart patients who are likely to benefit from cueing from those who may worsen their performance due to the stimulation.
有节奏的听觉提示可立即改善帕金森病患者的步态。然而，这种效果在不同患者之间差异很大。迄今为止，尚不清楚与这种个体差异相关的因素。患者的节奏能力和音乐素养（例如，感知和歌唱能力、对音乐的情感反应以及音乐训练）可能会促进对节奏提示的积极反应。为了验证这一假设，我们测量了39名非痴呆帕金森病患者和39名匹配的健康对照在基线状态以及有节奏提示时的步态。评估了他们的认知、节奏能力和一般音乐素养。当刺激导致步态速度出现具有临床意义的增加时，对提示的反应被判定为阳性。我们观察到，对提示有阳性反应的患者（n = 17）接受过更多音乐训练，在行走时更频繁地使步伐与节奏提示同步，并且与非阳性反应患者（n = 22）相比，表现出更好的音乐感知以及更差的认知灵活性。有6名患者在有节奏提示时的步态表现变差。我们得出结论，可通过音乐训练调节的节奏和音乐技能，可能会增强有节奏听觉提示对帕金森病的有益效果。根据音乐/节奏能力和音乐训练对患者进行筛查，可以区分出可能从提示中受益的患者和那些可能因刺激而使表现变差的患者。
