Labratory for Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement Cognition and Mobility (CMCM), Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Tel Aviv University, Tel Aviv, Israel.
Neurorehabil Neural Repair. 2020 Sep;34(9):795-803. doi: 10.1177/1545968320940985. Epub 2020 Jul 18.
. Nigrostriatal dopaminergic loss is a hallmark of Parkinson's disease (PD) pathophysiology, leading to motor Parkinsonism. Different intervention protocols have shown that motor and cognitive functions improvement in PD occur the modulation of distinct motor and cognitive pathways. . To investigate the effects of two motor training programs on the brains' functional networks in PD patients. . Thirty-seven PD patients were prospectively studied. All enrolled patients underwent either treadmill training (TT) (n = 19) or treadmill with virtual reality (TT + VR) (n = 18) for 6 weeks. Magnetic resonance imaging (MRI) scans (3 T) acquiring 3-dimensional T1-weighted and resting-state functional MRI (rs-fMRI) data sets were performed at baseline and after 6 weeks. Independent component analysis (ICA) was conducted, and functional connectivity (FC) changes within large-scale functional brain networks were examined. . In both groups, significant post-training FC decrease in striatal, limbic, and parietal regions within the basal ganglia network, executive control network, and frontal-striatal network, and significant FC increase in the caudate, and cingulate within the sensorimotor network (SMN) were observed. Moreover, a significant time × group interaction was detected where TT + VR training had greater effects on FC levels in the supplementary motor area (SMA) and right precentral gyrus within the SMN, and in the right middle frontal gyrus (MFG) within the cerebellar network. These FC alterations were associated with improved usual and dual-task walking performance. . These results suggest that TT with-and-without the addition of a VR component affects distinct neural pathways, highlighting the potential for beneficial neural plasticity in PD. Such distinctive task-specific pathways may foster the facilitation of interventions tailored to the individual needs of PD patients.
黑质纹状体多巴胺能丧失是帕金森病（PD）病理生理学的标志，导致运动性帕金森症。不同的干预方案表明，PD 患者的运动和认知功能改善是通过调节不同的运动和认知途径实现的。本研究旨在探讨两种运动训练方案对 PD 患者大脑功能网络的影响。
前瞻性研究了 37 名 PD 患者。所有入组患者均接受跑步机训练（TT）（n=19）或跑步机结合虚拟现实（TT+VR）（n=18）治疗 6 周。在基线和 6 周后分别进行磁共振成像（MRI）扫描（3T），采集 3 维 T1 加权和静息态功能 MRI（rs-fMRI）数据集。采用独立成分分析（ICA），并检查了大脑大尺度功能网络内的功能连接（FC）变化。
在两组中，均观察到基底节网络、执行控制网络和额纹状体网络内纹状体、边缘和顶叶区域以及感觉运动网络内尾状核和扣带回的 FC 显著降低，以及小脑网络内的 caudate 和 cingulate 的 FC 显著增加。此外，还检测到时间×组的交互作用，其中 TT+VR 训练对感觉运动网络内补充运动区（SMA）和右侧中央前回以及小脑网络内右侧额中回的 FC 水平具有更大的影响。这些 FC 变化与常规和双重任务行走表现的改善相关。
TT 结合和不结合 VR 成分会影响不同的神经通路，突出了 PD 中有益的神经可塑性的潜力。这种独特的任务特异性途径可能有助于促进针对 PD 患者个体需求的干预措施。
