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帕金森病在动态自主运动过程中表现出增强的肌间协调性。

Parkinson's Disease Exhibits Amplified Intermuscular Coherence During Dynamic Voluntary Action.

作者信息

Laine Christopher M, Valero-Cuevas Francisco J

机构信息

Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States.

Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, United States.

出版信息

Front Neurol. 2020 Apr 3;11:204. doi: 10.3389/fneur.2020.00204. eCollection 2020.

Abstract

Parkinson's disease (PD) is typically diagnosed and evaluated on the basis of overt motor dysfunction, however, subtle changes in the frequency spectrum of neural drive to muscles have been reported as well. During dynamic actions, coactive muscles of healthy adults often share a common source of 6-15 Hz (alpha-band) neural drive, creating synchronous alpha-band activity in their EMG signals. Individuals with PD commonly exhibit kinetic action tremor at similar frequencies, but the potential relationship between the intermuscular alpha-band neural drive seen in healthy adults and the action tremor associated with PD is not well-understood. A close relationship is most tenable during voluntary dynamic tasks where alpha-band neural drive is strongest in healthy adults, and where neural circuits affected by PD are most engaged. In this study, we characterized the frequency spectrum of EMG synchronization (intermuscular coherence) in 16 participants with PD and 15 age-matched controls during two dynamic motor tasks: (1) rotation of a dial between the thumb and index finger, and (2) dynamic scaling of isometric precision pinch force. These tasks produce different profiles of coherence between the first dorsal interosseous and abductor pollicis brevis muscles. We sought to determine if alpha-band intermuscular coherence would be amplified in participants with PD relative to controls, if such differences would be task-specific, and if they would correlate with symptom severity. We found that relative to controls, the PD group displayed amplified, but similarly task-dependent, coherence in the alpha-band. The magnitude of coherence during the rotation task correlated with overall symptom severity as per the UPDRS rating scale. Finally, we explored the potential for our coherence measures, with no additional information, to discriminate individuals with PD from controls. The area under the Receiver Operating Characteristic curve (AUC) indicated a clear separation between groups (AUC = 0.96), even though participants with PD were on their typical medication and displayed only mild-moderate symptoms. We conclude that a task-dependent, intermuscular neural drive within the alpha-band is amplified in PD. Its quantification via intermuscular coherence analysis may provide a useful tool for detecting the presence of PD, or assessing its progression.

摘要

帕金森病(PD)通常基于明显的运动功能障碍进行诊断和评估,然而,也有报道称神经对肌肉驱动的频谱存在细微变化。在动态动作过程中,健康成年人的协同活动肌肉通常共享6 - 15赫兹(α波段)神经驱动的共同来源,在其肌电图信号中产生同步的α波段活动。帕金森病患者通常在相似频率下表现出运动性动作震颤,但健康成年人中观察到的肌间α波段神经驱动与帕金森病相关的动作震颤之间的潜在关系尚未得到充分理解。在自愿动态任务中,这种密切关系最有可能成立,因为在这些任务中,健康成年人的α波段神经驱动最强,且受帕金森病影响的神经回路参与度最高。在本研究中,我们对16名帕金森病患者和15名年龄匹配的对照组在两项动态运动任务期间的肌电图同步(肌间相干性)频谱进行了特征分析:(1)拇指和食指之间旋转表盘,以及(2)等长精确捏力的动态缩放。这些任务在第一背侧骨间肌和拇短展肌之间产生了不同的相干性特征。我们试图确定相对于对照组,帕金森病患者的α波段肌间相干性是否会增强,这种差异是否具有任务特异性,以及它们是否与症状严重程度相关。我们发现,相对于对照组,帕金森病组在α波段显示出增强但同样依赖任务的相干性。根据统一帕金森病评定量表(UPDRS)评分,旋转任务期间的相干性大小与总体症状严重程度相关。最后,我们探讨了在无额外信息的情况下,我们的相干性测量方法区分帕金森病患者和对照组的潜力。受试者工作特征曲线(AUC)下的面积表明两组之间有明显区分(AUC = 0.96),尽管帕金森病患者正在服用其常用药物且仅表现出轻度至中度症状。我们得出结论,帕金森病中α波段内依赖任务的肌间神经驱动会增强。通过肌间相干性分析对其进行量化可能为检测帕金森病的存在或评估其进展提供一个有用的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/169a/7145888/e23149612e0d/fneur-11-00204-g0001.jpg

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