Universita' degli Studi di Roma Foro Italico, Roma, Italy; Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA.
Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA.
Neuroscience. 2019 Sep 15;416:168-176. doi: 10.1016/j.neuroscience.2019.07.024. Epub 2019 Jul 19.
Turning elicits Freezing of Gait (FoG) episodes in people with Parkinson's disease (PD) and is thought to require higher cortical control compared to straight ahead gait. Functional near infrared spectroscopy (fNIRS) has been used to examine prefrontal cortex (PFC) activity while walking, but the relationship between PFC activity and turn performance remains unclear. The aim of this pilot study was to examine PFC activity during turning in PD and healthy controls, and to investigate the association between PFC activity and turning. Thirty-two subjects, 15 freezers (PD + FoG) and 17 non-freezers (PD - FoG), and 8 controls were asked to perform a 2-min turning-in-place test under single-task (ST) and dual-task (DT) conditions. Each participant wore an fNIRS system to measure changes in oxyhemoglobin, as measure of PFC activity, and inertial sensors to quantify turning. Our results show a significant group (p = .050), task (p = .039), and interaction (p = .047) for the PFC activity during turning. Specifically, PD + FoG show higher PFC during turning compared to the other groups; PFC activity during DT is overall different compared to ST with an opposite trend in PD + FoG compared to controls and PD - FoG. In addition, higher PFC is associated with worse FoG in PD + FoG (r = 0.57, p = .048) and with lower number of turns in PD - FoG (r = -0.70, p = .002). The increased PFC activity in PD and the association between higher PFC activity and poorer turning performance may be a sign of poor movement automaticity in PD. Although further investigations are required, these pilot findings may guide development of personalized treatments to improve motor automaticity in PD.
转弯会引发帕金森病（PD）患者的冻结步态（FoG）发作，并且被认为需要比直走更高的皮质控制。功能性近红外光谱（fNIRS）已被用于检查行走时的前额叶皮层（PFC）活动，但 PFC 活动与转弯表现之间的关系仍不清楚。本初步研究旨在检查 PD 和健康对照组在转弯时的 PFC 活动，并研究 PFC 活动与转弯之间的关系。32 名受试者，15 名冻结者（PD+FoG）和 17 名非冻结者（PD-FoG）和 8 名对照者被要求在单任务（ST）和双任务（DT）条件下进行 2 分钟的原地转弯测试。每位参与者都佩戴了 fNIRS 系统，以测量前额叶皮层活动的变化，作为测量前额叶皮层活动的指标，并佩戴惯性传感器来量化转弯。我们的结果显示，转弯时的 PFC 活动存在显著的组间差异（p=0.050）、任务差异（p=0.039）和交互作用差异（p=0.047）。具体来说，PD+FoG 在转弯时比其他组表现出更高的 PFC；与 ST 相比，DT 期间的 PFC 活动总体上不同，PD+FoG 与对照组和 PD-FoG 的趋势相反。此外，PD+FoG 中 PFC 越高，FoG 越严重（r=0.57，p=0.048），PD-FoG 中 PFC 越高，转弯次数越少（r=-0.70，p=0.002）。PD 中 PFC 活动的增加以及 PFC 活动与较差的转弯表现之间的关联可能是 PD 中运动自动性较差的迹象。尽管需要进一步的研究，但这些初步发现可能有助于制定个性化治疗方案，以提高 PD 中的运动自动性。
