Al-Sharman Alham, Ismaiel Ismail Alhaj, Khalil Hanan, El-Salem Khalid
Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan.
Department of Neurosciences, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Front Neurol. 2021 Mar 2;12:582611. doi: 10.3389/fneur.2021.582611. eCollection 2021.
Despite the fact that sleep disturbances are among the most common and disabling manifestations of Parkinson's disease (PD), no study has investigated the effect of sleep quality and sleep-related biomarkers on motor skill acquisition in people with Parkinson's disease (PwPD). To examine the relationship between skill acquisition, sleep quality, and sleep-related biomarkers in PwPD using virtual reality (VR) system. This is a cross sectional study conducted on 31 PwPD and 31 healthy controls. To assess skill acquisition, each participant practiced a VR game 6 times (blocks). The main outcomes from the VR game were the required time to complete the VR game and the recorded errors. Motor skill acquisition was calculated as the difference of scores between block 6 and block 2 for both outcomes. Sleep was assessed subjectively using Pittsburgh Sleep Quality Index (PSQI) and objectively using the Actisleep. To assess sleep related biomarker, plasma serotonin level was examined. PwPD and healthy controls demonstrated a practice-related improvement in performance as shown by the main effect of block for each of the VR outcome measures ( < 0.000, time required to complete VR game; < 0.000, recorded errors). There was no interaction effect between Block X Group for both outcome measures. There were significant correlations in both groups ( < 0.05) between motor skill acquisition (as indicated by the difference of time required to complete the VR game between block 6 and block 2) and PSQI total score, wake after sleep onset, and sleep efficiency. Additionally, a significant correlation was observed in both groups between motor skill acquisition (as indicated by the difference of time required to complete the VR game between block 6 and block 2) and the plasma serotonin level ( < 0.05). These correlations in PwPD remained significant, even after adjusting for disease motor severity, cognitive status, depression, and daily dose of L-dopa. Sleep quality may influence motor skill acquisition in PwPD. Healthcare professionals are encouraged to be aware about sleep quality and sleep assessment tools. Therapies may target improving sleep quality which could result in improving motor skill acquisition.
尽管睡眠障碍是帕金森病（PD）最常见且致残的表现之一，但尚无研究调查睡眠质量和睡眠相关生物标志物对帕金森病患者（PwPD）运动技能习得的影响。本研究旨在使用虚拟现实（VR）系统，检验PwPD患者的技能习得、睡眠质量和睡眠相关生物标志物之间的关系。这是一项针对31名PwPD患者和31名健康对照者的横断面研究。为评估技能习得，每位参与者对一款VR游戏进行6次练习（组块）。VR游戏的主要结果是完成VR游戏所需的时间和记录的错误次数。运动技能习得通过计算两个结果中第6组块和第2组块得分的差值来衡量。使用匹兹堡睡眠质量指数（PSQI）主观评估睡眠情况，使用Actisleep客观评估睡眠情况。为评估睡眠相关生物标志物，检测血浆血清素水平。PwPD患者和健康对照者在表现上均呈现出与练习相关的改善，这体现在每个VR结果指标的组块主效应中（完成VR游戏所需时间，<0.000；记录的错误次数，<0.000）。对于两个结果指标，组块X组之间均无交互效应。两组中，运动技能习得（以第6组块和第2组块完成VR游戏所需时间的差值表示）与PSQI总分、睡眠后觉醒时间和睡眠效率之间均存在显著相关性（<0.05）。此外，两组中运动技能习得（以第6组块和第2组块完成VR游戏所需时间的差值表示）与血浆血清素水平之间也存在显著相关性（<0.05）。即使在对疾病运动严重程度、认知状态、抑郁和左旋多巴每日剂量进行校正后，PwPD患者中的这些相关性仍然显著。睡眠质量可能会影响PwPD患者的运动技能习得。鼓励医疗保健专业人员关注睡眠质量和睡眠评估工具。治疗可针对改善睡眠质量，这可能会改善运动技能习得。
