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帕金森病的运动记忆巩固缺陷:系统评价与荟萃分析。

Motor Memory Consolidation Deficits in Parkinson's Disease: A Systematic Review with Meta-Analysis.

机构信息

Memory and Motor Rehabilitation Laboratory (MEMORY-LAB), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR), Laval, QC, Canada.

School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada.

出版信息

J Parkinsons Dis. 2023;13(6):865-892. doi: 10.3233/JPD-230038.

Abstract

BACKGROUND

The ability to encode and consolidate motor memories is essential for persons with Parkinson's disease (PD), who usually experience a progressive loss of motor function. Deficits in memory encoding, usually expressed as poorer rates of skill improvement during motor practice, have been reported in these patients. Whether motor memory consolidation (i.e., motor skill retention) is also impaired is unknown.

OBJECTIVE

To determine whether motor memory consolidation is impaired in PD compared to neurologically intact individuals.

METHODS

We conducted a pre-registered systematic review (PROSPERO: CRD42020222433) following PRISMA guidelines that included 46 studies.

RESULTS

Meta-analyses revealed that persons with PD have deficits in retaining motor skills (SMD = -0.17; 95% CI = -0.32, -0.02; p = 0.0225). However, these deficits are task-specific, affecting sensory motor (SMD = -0.31; 95% CI -0.47, -0.15; p = 0.0002) and visuomotor adaptation (SMD = -1.55; 95% CI = -2.32, -0.79; p = 0.0001) tasks, but not sequential fine motor (SMD = 0.17; 95% CI = -0.05, 0.39; p = 0.1292) and gross motor tasks (SMD = 0.04; 95% CI = -0.25, 0.33; p = 0.7771). Importantly, deficits became non-significant when augmented feedback during practice was provided, and additional motor practice sessions reduced deficits in sensory motor tasks. Meta-regression analyses confirmed that deficits were independent of performance during encoding, as well as disease duration and severity.

CONCLUSION

Our results align with the neurodegenerative models of PD progression and motor learning frameworks and emphasize the importance of developing targeted interventions to enhance motor memory consolidation in PD.

摘要

背景

编码和巩固运动记忆的能力对于帕金森病(PD)患者至关重要,因为他们通常会经历运动功能的逐渐丧失。这些患者的记忆编码能力存在缺陷,通常表现为在进行运动练习时技能提高的速度较慢。但是,运动记忆巩固(即运动技能保持)是否也受到损害尚不清楚。

目的

确定与神经正常个体相比,PD 是否存在运动记忆巩固受损的情况。

方法

我们按照 PRISMA 指南进行了预先注册的系统评价(PROSPERO:CRD42020222433),其中包括 46 项研究。

结果

荟萃分析显示,PD 患者在保留运动技能方面存在缺陷(SMD = -0.17;95%CI = -0.32,-0.02;p = 0.0225)。然而,这些缺陷是特定于任务的,影响感觉运动(SMD = -0.31;95%CI = -0.47,-0.15;p = 0.0002)和视觉运动适应(SMD = -1.55;95%CI = -2.32,-0.79;p = 0.0001)任务,但不影响顺序精细运动(SMD = 0.17;95%CI = -0.05,0.39;p = 0.1292)和粗大运动任务(SMD = 0.04;95%CI = -0.25,0.33;p = 0.7771)。重要的是,当在练习过程中提供增强反馈时,缺陷变得不显著,并且额外的运动练习减少了感觉运动任务中的缺陷。元回归分析证实,缺陷与编码期间的表现以及疾病持续时间和严重程度无关。

结论

我们的研究结果与 PD 进展的神经退行性模型和运动学习框架一致,并强调了开发针对运动记忆巩固的靶向干预措施的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faf1/10578244/6a7e079a0805/jpd-13-jpd230038-g001.jpg

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