Cucca Alberto, Di Rocco Alessandro, Acosta Ikuko, Beheshti Mahya, Berberian Marygrace, Bertisch Hilary C, Droby Amgad, Ettinger Tom, Hudson Todd E, Inglese Matilde, Jung Yoon J, Mania Daniella F, Quartarone Angelo, Rizzo John-Ross, Sharma Kush, Feigin Andrew, Biagioni Milton C, Ghilardi M Felice
The Marlene and Paolo Fresco Institute for Parkinson's and Movement Disorders, Department of Neurology, NYU School of Medicine, New York, NY, USA; Department of Life Sciences, University of Trieste, Trieste, Italy; Department of Physical Medicine and Rehabilitation, Villa Margherita Fresco Parkinson Center, Vicenza, Italy.
Department of Neurology, Zucker School of Medicine, Hofstra/Northwell Health, New York, NY, USA.
Parkinsonism Relat Disord. 2021 Mar;84:148-154. doi: 10.1016/j.parkreldis.2021.01.013. Epub 2021 Jan 23.
To explore the potential rehabilitative effect of art therapy and its underlying mechanisms in Parkinson's disease (PD).
Observational study of eighteen patients with PD, followed in a prospective, open-label, exploratory trial. Before and after twenty sessions of art therapy, PD patients were assessed with the UPDRS, Pegboard Test, Timed Up and Go Test (TUG), Beck Depression Inventory (BDI), Modified Fatigue Impact Scale and PROMIS-Self-Efficacy, Montreal Cognitive Assessment, Rey-Osterrieth Complex Figure Test (RCFT), Benton Visual Recognition Test (BVRT), Navon Test, Visual Search, and Stop Signal Task. Eye movements were recorded during the BVRT. Resting-state functional MRI (rs-fMRI) was also performed to assess functional connectivity (FC) changes within the dorsal attention (DAN), executive control (ECN), fronto-occipital (FOC), salience (SAL), primary and secondary visual (V1, V2) brain networks. We also tested fourteen age-matched healthy controls at baseline.
At baseline, PD patients showed abnormal visual-cognitive functions and eye movements. Analyses of rs-fMRI showed increased functional connectivity within DAN and ECN in patients compared to controls. Following art therapy, performance improved on Navon test, eye tracking, and UPDRS scores. Rs-fMRI analysis revealed significantly increased FC levels in brain regions within V1 and V2 networks.
Art therapy improves overall visual-cognitive skills and visual exploration strategies as well as general motor function in patients with PD. The changes in brain connectivity highlight a functional reorganization of visual networks.
探讨艺术疗法对帕金森病（PD）的潜在康复作用及其潜在机制。
对18例PD患者进行观察性研究，采用前瞻性、开放标签、探索性试验。在进行20次艺术疗法前后，使用统一帕金森病评定量表（UPDRS）、钉板试验、定时起立行走测试（TUG）、贝克抑郁量表（BDI）、改良疲劳影响量表和患者报告结果测量信息系统-自我效能感、蒙特利尔认知评估、雷-奥斯特里赫复杂图形测试（RCFT）、本顿视觉识别测试（BVRT）、纳冯测试、视觉搜索和停止信号任务对PD患者进行评估。在BVRT过程中记录眼动。还进行了静息态功能磁共振成像（rs-fMRI），以评估背侧注意网络（DAN）、执行控制网络（ECN）、额枕网络（FOC）、突显网络（SAL）、初级和次级视觉网络（V1、V2）内的功能连接（FC）变化。我们还在基线时对14名年龄匹配的健康对照者进行了测试。
在基线时，PD患者表现出视觉认知功能和眼动异常。rs-fMRI分析显示，与对照组相比，患者的DAN和ECN内功能连接增加。经过艺术疗法后，纳冯测试、眼动追踪和UPDRS评分的表现有所改善。rs-fMRI分析显示，V1和V2网络内脑区的FC水平显著增加。
艺术疗法可改善PD患者的整体视觉认知技能、视觉探索策略以及一般运动功能。脑连接的变化突出了视觉网络的功能重组。
