Wang Jie, Li Yingqi, Wang Yingpeng, Wang Congxiao, Qie Shuyan, Jin Zhaohui, Du Wenjun
Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China.
Parkinson Medical Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2024 Feb 27;15:1336268. doi: 10.3389/fneur.2024.1336268. eCollection 2024.
A large number of literatures show that rhythmic auditory stimulation (RAS) can effectively improve Parkinson's disease (PD) patients' gait speed, frequency and speed. Its application and curative effect on upper limb motor function is relatively few.
By studying the immediate effect of RAS with different rhythms on the prefrontal cortex (PFC) blood oxygen response during upper limb movement in PD patients, this study discusses the potential neurophysiological mechanism of RAS on upper limb movement in PD patients, which is expected to provide guidance for patients with upper limb dysfunction such as Parkinson's disease.
In this study, 31 PD patients with upper limb static tremors were recruited to complete the nail board task on the healthy upper limb under the baseline rhythm, slow rhythm and fast rhythm provided by the therapist. At the same time, fNIRS was used to observe the blood oxygen response of PFC.
There was no significant main effect onsidein all brain regions ( > 0.05), and there was no interaction between rhythm and side ( > 0.05); Except lPFC, the main effect of rhythm in other brain regions was significant ( < 0.05), and ΔHbO increased with the change of rhythm. Paired analysis showed that there were significant differences in ΔHbO between slow rhythm and baseline rhythm, between fast rhythm and baseline rhythm, and between slow rhythm and fast rhythm ( < 0.05); The ΔHbO of rPFC, lDLPFC and rDLPFC were significantly different between slow rhythm and fast rhythm ( < 0.05); there were significant differences in the ΔHbO of BA8 between slow rhythm and baseline rhythm, and between slow rhythm and fast rhythm ( < 0.05).
RAS may be a useful upper limb rehabilitation strategy for PD patients with upper limb dysfunction. At the same time, RAS with different rhythms also have different responses to PFC blood oxygen during upper limb movement in PD patients, so that we can design interventions for this kind of cortical mechanism. Identifying the neurophysiological mechanism of RAS on upper limb movement in PD patients may help clinicians customize rehabilitation methods for patients according to clues, so as to highly personalize upper limb training and optimize its effect.
大量文献表明，节律性听觉刺激（RAS）能有效提高帕金森病（PD）患者的步态速度、频率和步幅。其对上肢运动功能的应用及疗效相对较少。
通过研究不同节律的RAS对PD患者上肢运动过程中前额叶皮质（PFC）血氧反应的即时效应，探讨RAS对PD患者上肢运动的潜在神经生理机制，以期为帕金森病等上肢功能障碍患者提供指导。
本研究招募了31例存在上肢静止性震颤的PD患者，在治疗师提供的基线节律、慢节律和快节律下，于健侧上肢完成钉板任务。同时，采用功能近红外光谱技术（fNIRS）观察PFC的血氧反应。
所有脑区在侧别上均无显著主效应（>0.05），节律与侧别之间也无交互作用（>0.05）；除左前额叶皮质（lPFC）外，其他脑区节律的主效应显著（<0.05），且脱氧血红蛋白（ΔHbO）随节律变化而增加。配对分析显示，慢节律与基线节律之间、快节律与基线节律之间以及慢节律与快节律之间的ΔHbO存在显著差异（<0.05）；右前额叶皮质（rPFC）、左背外侧前额叶皮质（lDLPFC）和右背外侧前额叶皮质（rDLPFC）的ΔHbO在慢节律与快节律之间存在显著差异（<0.05）；8区（BA8）的ΔHbO在慢节律与基线节律之间以及慢节律与快节律之间存在显著差异（<0.05）。
RAS可能是改善PD患者上肢功能障碍的一种有效上肢康复策略。同时，不同节律的RAS对PD患者上肢运动过程中PFC血氧也有不同反应，据此可为这种皮质机制设计干预措施。明确RAS对PD患者上肢运动的神经生理机制，可能有助于临床医生根据线索为患者定制康复方法，从而高度个性化上肢训练并优化其效果。
