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轻度至中度帕金森病患者的内隐运动序列学习:行为及相关脑功能。

Implicit Motor Sequence Learning in People with Mild to Moderate Parkinson's Disease: Behavior and Related Brain Function.

机构信息

Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, Stockholm, Sweden.

Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.

出版信息

J Parkinsons Dis. 2023;13(3):367-378. doi: 10.3233/JPD-223480.

Abstract

BACKGROUND

Deficits in motor learning could be an important explanation for the balance and gait impairments characteristic of people with Parkinson's disease (PD). Empirical studies often report that so-called implicit motor sequence learning is impaired in people with PD, but the results are inconclusive. Altered brain activity during implicit motor sequence learning has also been reported for people with PD in comparison to healthy individuals.

OBJECTIVE

To investigate implicit motor sequence learning and associated neural correlates in individuals with mild to moderate PD.

METHODS

Fifty-seven participants with PD and 34 healthy participants, all ≥60 years of age, performed the serial reaction time task (SRTT) during the acquisition of functional magnetic resonance imaging (fMRI) data. We analyzed the SRTT as a measure of implicit motor sequence learning in two complementary ways. We analyzed the task-induced fMRI data within regions of interest (ROIs) as well as functional connectivity between ROIs.

RESULTS

We found a significant group difference in SRTT performance indicating that the participants with PD had a somewhat lower level of implicit motor sequence learning than the healthy participants. Exploratory analyses suggested that impairments in implicit motor sequence learning for people with PD might be due to a lower learning rate. We did not find any significant group differences in the fMRI data.

CONCLUSION

Our exploratory finding of a lower implicit motor learning rate in PD could have important implications for how people with PD should practice new motor tasks and physical exercise. Future studies need to confirm this finding with hypothesis-driven analyses.

摘要

背景

运动学习缺陷可能是帕金森病(PD)患者平衡和步态障碍的一个重要解释。实证研究经常报告 PD 患者所谓的内隐运动序列学习受损,但结果并不一致。与健康个体相比,PD 患者在进行内隐运动序列学习时大脑活动也发生了改变。

目的

研究轻度至中度 PD 个体的内隐运动序列学习及其相关的神经相关性。

方法

57 名 PD 患者和 34 名年龄均≥60 岁的健康参与者在进行功能磁共振成像(fMRI)数据采集期间完成了序列反应时间任务(SRTT)。我们以两种互补的方式分析 SRTT,作为内隐运动序列学习的衡量标准。我们在感兴趣区域(ROI)内分析任务诱发的 fMRI 数据,以及 ROI 之间的功能连接。

结果

我们发现 SRTT 表现存在显著的组间差异,表明 PD 患者的内隐运动序列学习水平略低于健康参与者。探索性分析表明,PD 患者内隐运动序列学习的损伤可能是由于学习率较低。我们在 fMRI 数据中没有发现任何显著的组间差异。

结论

我们在 PD 中发现的内隐运动学习率较低的探索性发现,可能对内隐运动序列学习受损的 PD 患者如何练习新的运动任务和体育锻炼具有重要意义。未来的研究需要通过假设驱动的分析来证实这一发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13d9/10200162/16de70151644/jpd-13-jpd223480-g001.jpg

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