Functional Imaging and Cognitive-Affective Neuroscience Lab (fINCAN), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University, Istanbul, Turkey.
Department of Physical Therapy and Rehabilitation, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey.
Sci Rep. 2022 May 16;12(1):8024. doi: 10.1038/s41598-022-12061-3.
There are few studies investigating the short-term effects of Virtual Reality based Exergaming (EG) on motor and cognition simultaneously and pursue the brain functional activity changes after these interventions in patients with Parkinson's Disease (PD). The purpose of this study was to investigate the synergistic therapeutic effects of Virtual Reality based EG on motor and cognitive symptoms in PD and its possible effects on neuroplasticity. Eligible patients with the diagnosis of PD were randomly assigned to one of the two study groups: (1) an experimental EG group, (2) an active control Exercise Therapy (ET) group. All patients participated in a 4-week exercise program consisting of 12 treatment sessions. Every session lasted 60 min. Participants underwent a motor evaluation, extensive neuropsychological assessment battery and rs-fMRI before and after the interventions. Thirty patients fulfilled the inclusion criteria and were randomly assigned to the EG and ET groups. After the dropouts, 23 patients completed the assessments and interventions (11 in EG, 13 in ET). Within group analysis showed significant improvements in both groups. Between group comparisons considering the interaction of group × time effect, showed superiority of EG in terms of general cognition, delayed visual recall memory and Boston Naming Test. These results were consistent in the within-group and between-group analysis. Finally, rs-fMRI analysis showed increased activity in the precuneus region in the time × group interaction in the favor of EG group. EG can be an effective alternative in terms of motor and cognitive outcomes in patients with PD. Compared to ET, EG may affect brain functional connectivity and can have beneficial effects on patients' cognitive functions and motor symptoms. Whenever possible, using EG and ET in combination, may have the better effects on patients daily living and patients can benefit from the advantages of both interventions.
目前很少有研究同时调查基于虚拟现实的运动游戏（EG）对运动和认知的短期影响，并探讨这些干预措施后帕金森病（PD）患者大脑功能活动的变化。本研究旨在探讨基于虚拟现实的 EG 对 PD 患者运动和认知症状的协同治疗效果及其对神经可塑性的可能影响。符合条件的 PD 患者被随机分配到以下两个研究组之一：（1）实验组，（2）主动对照组。所有患者均参加了一项为期 4 周的运动方案，包括 12 次治疗。每次治疗持续 60 分钟。参与者在干预前后进行了运动评估、广泛的神经心理学评估和 rs-fMRI 检查。30 名患者符合纳入标准，并被随机分配到 EG 和 ET 组。在失访后，23 名患者完成了评估和干预（EG 组 11 名，ET 组 13 名）。组内分析显示两组均有显著改善。考虑到组间时间效应的交互作用的组间比较显示，EG 在一般认知、延迟视觉回忆记忆和波士顿命名测试方面具有优势。这些结果在组内和组间分析中是一致的。最后，rs-fMRI 分析显示，在时间组间交互作用中，precuneus 区域的活性增加有利于 EG 组。EG 可作为 PD 患者运动和认知结果的有效替代方法。与 ET 相比，EG 可能会影响大脑功能连接，并可能对患者的认知功能和运动症状产生有益影响。只要有可能，将 EG 和 ET 联合使用，可能会对患者的日常生活产生更好的效果，患者可以从两种干预措施的优势中受益。
