D'Cruz Nicholas, De Vleeschhauwer Joni, Putzolu Martina, Nackaerts Evelien, Gilat Moran, Nieuwboer Alice
Research Group for Neurorehabilitation (eNRGy), Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, Box 1500, B-3001 Leuven, Belgium.
Department of Experimental Medicine (DIMES), Section of Human Physiology, University of Genoa, 16132 Genoa, Italy.
Brain Sci. 2024 Apr 12;14(4):376. doi: 10.3390/brainsci14040376.
The prediction of motor learning in Parkinson's disease (PD) is vastly understudied. Here, we investigated which clinical and neural factors predict better long-term gains after an intensive 6-week motor learning program to ameliorate micrographia. We computed a composite score of learning through principal component analysis, reflecting better writing accuracy on a tablet in single and dual task conditions. Three endpoints were studied-acquisition (pre- to post-training), retention (post-training to 6-week follow-up), and overall learning (acquisition plus retention). Baseline writing, clinical characteristics, as well as resting-state network segregation were used as predictors. We included 28 patients with PD (13 freezers and 15 non-freezers), with an average disease duration of 7 (±3.9) years. We found that worse baseline writing accuracy predicted larger gains for acquisition and overall learning. After correcting for baseline writing accuracy, we found female sex to predict better acquisition, and shorter disease duration to help retention. Additionally, absence of FOG, less severe motor symptoms, female sex, better unimanual dexterity, and better sensorimotor network segregation impacted overall learning positively. Importantly, three factors were retained in a multivariable model predicting overall learning, namely baseline accuracy, female sex, and sensorimotor network segregation. Besides the room to improve and female sex, sensorimotor network segregation seems to be a valuable measure to predict long-term motor learning potential in PD.
帕金森病(PD)中运动学习的预测研究严重不足。在此,我们调查了哪些临床和神经因素可预测在为期6周的强化运动学习计划以改善小写症后能获得更好的长期收益。我们通过主成分分析计算了一个学习综合评分,反映在单任务和双任务条件下在平板电脑上更好的书写准确性。研究了三个终点——习得(训练前到训练后)、保持(训练后到6周随访)和总体学习(习得加保持)。基线书写、临床特征以及静息态网络分离被用作预测指标。我们纳入了28例帕金森病患者(13例冻结者和15例非冻结者),平均病程为7(±3.9)年。我们发现基线书写准确性越差,习得和总体学习的收益越大。在校正基线书写准确性后,我们发现女性性别可预测更好的习得,病程较短有助于保持。此外,无冻结步态、运动症状较轻、女性性别、单手灵活性较好以及感觉运动网络分离较好对总体学习有积极影响。重要的是,在预测总体学习的多变量模型中保留了三个因素,即基线准确性、女性性别和感觉运动网络分离。除了有待改善的方面和女性性别外,感觉运动网络分离似乎是预测帕金森病长期运动学习潜力的一个有价值的指标。