School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; School of Medicine, Jinhua Polytechnic, Jinhua, Zhejiang 321013, China.
Department of Rehabilitation Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai 200434, China.
Behav Brain Res. 2023 Feb 13;438:114219. doi: 10.1016/j.bbr.2022.114219. Epub 2022 Nov 17.
Using functional near-infrared spectroscopy (fNIRS), hemodynamic responses (i.e., changes in oxygenated and deoxygenated hemoglobin) were measured while participants with Parkinson's disease (PD) and healthy controls performed the Timed-Up-and-Go test (TUGT), and differences in cortical activity at baseline and three different intervals were examined between the two groups. Seventeen PD patients and twenty-two controls participated in the study, but two PD patients were excluded from statistical analysis due to the presence of freezing of gait and using walking aids during the TUGT. During the TUGT, activity in the front, left, right and total frontal cortices initially decreased significantly, then significantly increased in PD participants and low-risk faller PD participants, compared to when in a sitting position. ΔHbO (HbO change from baseline) over the front, left and total frontal cortices in the PD group was significantly lower than the control group in interval 1 (P = 0.019, P = 0.014 and P = 0.031, respectively), while significantly higher than the control group in interval 2 over the left frontal cortex (P = 0.010). No significant differences were observed between the high-risk faller and low-risk faller subgroups of PD participants in ΔHbO and ΔHbR in the three intervals (P > 0.05). In the high-risk faller subgroup, ΔHbO over the left frontal cortex was significantly higher than the right frontal cortex in interval 2 and interval 3 (P = 0.015, P = 0.030, respectively). There was a strong positive correlation between education and HbR concentration over the right frontal cortex in PD participants (rho = 0.557, P = 0.031), while there were strong negative correlations between PD duration and HbR concentration over the right and total frontal cortices in the high-risk faller subgroup of PD participants (rho = -0.854, P = 0.014 for the right; rho = -0.784, P = 0.037 for the total). The falls prediction cutoff TUGT time for PD participants was 14.2 s. These results suggest that frontal cognition training, along with exercise training, could be used as an effective training method to improve motor performance in PD patients, especially for those at high-risk for falls.
使用功能近红外光谱 (fNIRS)，当帕金森病 (PD) 患者和健康对照组进行计时起立行走测试 (TUGT) 时，测量了血液动力学反应（即含氧和去氧血红蛋白的变化），并检查了两组在基线和三个不同时间间隔内皮质活动的差异。17 名 PD 患者和 22 名对照组参加了这项研究，但由于在 TUGT 期间出现步态冻结和使用助行器，两名 PD 患者被排除在统计分析之外。在 TUGT 期间，与坐立时相比，PD 参与者和低跌倒风险 PD 参与者的额叶、左侧、右侧和总额叶皮质的活动最初显著下降，然后显著增加。与对照组相比，PD 组在间隔 1 时额、左和总额皮质的ΔHbO（HbO 与基线的变化）明显较低（P=0.019、P=0.014 和 P=0.031），而在间隔 2 时左额叶皮质的ΔHbO 明显高于对照组（P=0.010）。在三个间隔内，PD 参与者的高跌倒风险亚组和低跌倒风险亚组之间，ΔHbO 和 ΔHbR 无显著差异（P>0.05）。在高跌倒风险亚组中，间隔 2 和间隔 3 时左额叶皮质的ΔHbO 明显高于右侧额叶皮质（P=0.015、P=0.030）。PD 参与者右侧额叶皮质的 HbR 浓度与教育程度呈强正相关（rho=0.557，P=0.031），而高跌倒风险亚组的 PD 患者右侧和总额叶皮质的 HbR 浓度与 PD 持续时间呈强负相关（rho=-0.854，P=0.014，右侧；rho=-0.784，P=0.037，总）。PD 参与者的跌倒预测 TUGT 时间截点为 14.2 秒。这些结果表明，额叶认知训练与运动训练相结合，可以作为一种有效的训练方法，改善 PD 患者的运动表现，尤其是对那些有跌倒高风险的患者。
