Hajebrahimi Farzin, Cakir Tansel, Hanoglu Lutfu
Department of Physical Therapy and Rehabilitation, School of Health Sciences, Istanbul Medipol University, Istanbul, Turkey.
Physical Therapy and Rehabilitation PhD Program, Graduate School of Health Sciences, Istanbul Medipol University, Istanbul, Turkey.
Case Rep Neurol. 2020 Jul 1;12(2):238-246. doi: 10.1159/000508492. eCollection 2020 May-Aug.
Corticobasal syndrome (CBS) is a rare progressive neurodegenerative disease characterized by a combination of asymmetric motor symptoms and non-motor symptoms. CBS is poorly responsive to levodopa. Non-pharmacological strategies have been found to be useful as components of a multidisciplinary therapeutic approach for patients with CBS. The purpose of this study was to investigate the effects of virtual reality training in addressing symptoms of CBS. A 64-year-old man was clinically diagnosed as CBS one year after the onset of complaints. Positron emission tomography (PET) scan showed asymmetrical hypometabolism in the right thalamus and basal ganglia. The patient was evaluated for balance, gait, mobility, and cognition 1 week before, 1 week after, and 1 year after 6 weeks of training, 3 times weekly (18 sessions in total). All clinical outcomes and PET result had improved after the intervention; cognition and balance were maintained after 1 year. Additionally, the asymmetric hypometabolism, which had been detectable on the PET scan, became normal, and a relative improvement was noted in the visual evaluation of cortical involvement. Virtual reality may address different aspects of motor and cognition and possibly brain metabolic changes that can affect the course of the disease in patients with CBS.
皮质基底节综合征(CBS)是一种罕见的进行性神经退行性疾病,其特征为不对称运动症状和非运动症状并存。CBS对左旋多巴反应不佳。已发现非药物策略作为CBS患者多学科治疗方法的组成部分是有用的。本研究的目的是调查虚拟现实训练对CBS症状的影响。一名64岁男性在出现症状一年后被临床诊断为CBS。正电子发射断层扫描(PET)显示右侧丘脑和基底节不对称代谢减低。在训练前1周、训练后1周以及6周训练(每周3次,共18次)后1年对患者进行平衡、步态、活动能力和认知评估。干预后所有临床结果和PET结果均有改善;1年后认知和平衡得以维持。此外,PET扫描中可检测到的不对称代谢减低变得正常,并且在皮质受累的视觉评估中观察到相对改善。虚拟现实可能解决运动和认知的不同方面问题,并可能影响CBS患者疾病进程的脑代谢变化。