São Paulo State University (UNESP), School of Sciences, Graduate Program in Movement Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), Bauru, Brazil.
São Paulo State University (UNESP), School of Sciences, Graduate Program in Movement Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), Bauru, Brazil; REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.
Brain Res. 2022 Jan 15;1775:147727. doi: 10.1016/j.brainres.2021.147727. Epub 2021 Nov 14.
Our understanding of how balance control responds to levodopa over the course of a single day in people with Parkinson's disease (PD) is limited with the majority of studies focused on isolated comparisons of ON vs. OFF levodopa medication.
To evaluate the temporal dynamics of postural control following the first levodopa dose of the day during a challenging standing task in a group of people with PD.
Changes in postural control were evaluated by monitoring cortical activity (covering frontal, motor, parietal and occipital areas), body sway parameters (force platform), and lower limb muscle activity (tibialis anterior and gastrocnemius medialis) in 15 individuals with PD during a semi-tandem standing task. Participants were assessed during two 60 second trials every 30 minutes (ON-30 ON-60 etc.) for 3 hours after the first matinal dose (ON-180).
Compared to when tested OFF-medication, cortical activity was increased across all four regions from ON-60 to ON-120 with early increases in alpha and beta band activity observed at ON-30. Levodopa was associated with increased gastrocnemius medialis activity (ON-30 to ON-120) and ankle co-contraction (ON-60 to ON-120). Changes in body sway outcomes (particularly in the anterior-posterior direction) were evident from ON-60 to ON-120.
Our results reveal a 60-minute window within which postural control outcomes may be obtained that are different compared to OFF-state and remain stable (from 60-minutes to 120-minutes after levodopa intake). Identifying a window of opportunity for measurement when individuals are optimally medicated is important for observations in a clinical and research setting.
我们对于帕金森病（PD）患者一天中单剂量左旋多巴治疗后平衡控制如何响应的理解是有限的，因为大多数研究都集中在孤立的 ON 与 OFF 左旋多巴药物比较上。
评估 PD 患者在一项具有挑战性的站立任务中，接受一天中的第一剂左旋多巴后姿势控制的时间动态。
通过监测皮质活动（覆盖额、运动、顶和枕区）、身体摆动参数（力平台）和下肢肌肉活动（胫骨前肌和腓肠肌内侧），在 15 名 PD 患者在半串联站立任务中评估姿势控制的变化。参与者在接受第一剂晨服后每 30 分钟评估两次 60 秒试验（ON-30、ON-60 等），持续 3 小时（ON-180）。
与 OFF 药物相比，皮质活动在 ON-60 到 ON-120 期间在所有四个区域都增加，在 ON-30 时观察到α和β频段活动的早期增加。左旋多巴与腓肠肌内侧活动（ON-30 到 ON-120）和踝关节协同收缩（ON-60 到 ON-120）增加有关。从 ON-60 到 ON-120，身体摆动结果（特别是在前-后方向）的变化是明显的。
我们的结果揭示了一个 60 分钟的窗口期，在此期间可能获得与 OFF 状态不同的姿势控制结果，并且从左旋多巴摄入后 60 分钟到 120 分钟保持稳定。在个体最佳用药时确定测量的机会窗口对于临床和研究观察非常重要。
