Maetzler Walter, Geritz Johanna, Stagneth Lina, Emmert Kirsten
Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Christian-Albrechts-Universität zu Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Deutschland.
Nervenarzt. 2024 Jun;95(6):516-524. doi: 10.1007/s00115-024-01614-8. Epub 2024 Feb 15.
A recently published concept considers a significant proportion of the occurrence and persistence of functional movement disorders (FMD) to be explained by increased/incorrect weighting of the expected movement (feedforward signal) in the presence of decreased/altered actual feedback of the movement. In the context of aging and age-associated diseases, there is an increased likelihood that these prerequisites will occur, also in combination. For example, the feedforward signal can be enhanced by accumulation of a wealth of experience but can for example become prone to error due to changes in attention and (fear of) falling. Conversely, the actual feedback is subject to age-related changes, such as reduction of sensory functions. This could explain why FMDs also occur in old age and offer treatment approaches for this so far poorly studied disorder. It follows that a specific focus on (the correction of) feedforward signals and strengthening as well as training of the actual feedback are potentially promising therapeutic approaches for older people with FMD.
最近发表的一个概念认为,功能性运动障碍(FMD)的发生和持续存在很大一部分原因是在运动的实际反馈减少/改变的情况下,预期运动(前馈信号)的权重增加/错误。在衰老和与年龄相关的疾病背景下,这些先决条件出现的可能性增加,而且可能同时出现。例如,前馈信号可以通过丰富经验的积累而增强,但也可能由于注意力变化和(对)跌倒的恐惧而容易出错。相反,实际反馈会受到与年龄相关的变化影响??,如感觉功能减退。这可以解释为什么FMD也会在老年时出现,并为这种迄今为止研究较少的疾病提供治疗方法。由此可见,特别关注(纠正)前馈信号以及加强和训练实际反馈,对于患有FMD的老年人来说可能是很有前景的治疗方法。