Bolzoni Francesco, Esposti Roberto, Marchese Silvia M, Pozzi Nicoló G, Ramirez-Pasos Uri E, Isaias Ioannis U, Cavallari Paolo
Human Physiology Section of the Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
Department of Neurology, University Hospital and Julius Maximilians University Würzburg, Würzburg, Germany.
Front Physiol. 2018 Dec 3;9:1745. doi: 10.3389/fphys.2018.01745. eCollection 2018.
Voluntary movements induce postural perturbations which are counteracted by anticipatory postural adjustments (APAs). These actions are known to build up long fixation chains toward available support points ( APAs), so as to grant whole body equilibrium. Moreover, recent studies highlighted that APAs also build-up short fixation chains, within the same limb where a distal segment is moved ( APAs), aimed at stabilizing the proximal segments. The neural structures generating intra-limb APAs still need investigations; the present study aims to compare focal movement kinematics and intra-limb APA latencies and pattern between healthy subjects and parkinsonian patients, assuming the latter as a model of basal ganglia dysfunction. Intra-limb APAs that stabilize the arm when the index-finger is briskly flexed were recorded in 13 parkinsonian patients and in 10 age-matched healthy subjects. Index-finger movement was smaller in parkinsonian patients vs. healthy subjects ( = 0.01) and more delayed with respect to the onset of the prime mover flexor digitorum superficialis (FDS, < 0.0001). In agreement with the literature, in all healthy subjects the FDS activation was preceded by an inhibitory intra-limb APA in biceps brachii (BB) and anterior deltoid (AD), and almost simultaneous to an excitatory intra-limb APA in triceps brachii (TB). In parkinsonian patients, no significant differences were found for TB and AD intra-limb APA timings, however only four patients showed an inhibitory intra-limb APA in BB, while other four did not show any BB intra-limb APAs and five actually developed a BB excitation. The frequency of occurrence of , , and BB APAs was different in healthy vs. parkinsonian participants ( = 0.0016). The observed alterations in index-finger kinematics and intra-limb APA pattern in parkinsonian patients suggest that basal ganglia, in addition to shaping the focal movement, may also contribute to intra-limb APA control.
自主运动诱发姿势扰动，而预期姿势调整（APAs）可抵消这些扰动。已知这些动作会朝着可用支撑点（APAs）建立长固定链，以实现全身平衡。此外，最近的研究强调，APAs还会在同一肢体（远端节段移动的肢体）内建立短固定链，旨在稳定近端节段。产生肢体内部APAs的神经结构仍需研究；本研究旨在比较健康受试者和帕金森病患者之间的局部运动运动学、肢体内部APAs潜伏期和模式，将后者作为基底神经节功能障碍的模型。在13名帕金森病患者和10名年龄匹配的健康受试者中记录了食指快速屈曲时稳定手臂的肢体内部APAs。与健康受试者相比，帕金森病患者的食指运动较小（P = 0.01），且相对于主要运动肌浅屈指肌（FDS）的起始延迟更多（P < 0.0001）。与文献一致，在所有健康受试者中，FDS激活之前，肱二头肌（BB）和三角肌前部（AD）会出现抑制性肢体内部APAs，几乎与肱三头肌（TB）的兴奋性肢体内部APAs同时出现。在帕金森病患者中，TB和AD肢体内部APAs的时间没有显著差异，然而只有4名患者在BB中表现出抑制性肢体内部APAs，而其他4名患者没有表现出任何BB肢体内部APAs，5名患者实际上出现了BB兴奋。健康受试者和帕金森病参与者中BB APAs的出现频率不同（P = 0.0016）。帕金森病患者中观察到的食指运动学和肢体内部APAs模式的改变表明，基底神经节除了塑造局部运动外，还可能有助于肢体内部APAs的控制。
