School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Geroscience. 2024 Dec;46(6):6283-6299. doi: 10.1007/s11357-024-01236-7. Epub 2024 Jun 18.
Anxiety and postural control deficits may be related in people with Parkinson's disease (PwPD). However, the association between anxiety levels and weight-shifting control remains ambiguous. This study investigated whether 1) weight-shifting control differed between PwPD with and without anxiety, and 2) the learning effect of weight-shifting differed between the two populations. Additionally, we evaluated cortical activities to investigate neural mechanisms underlying weight-shifting control. Twenty-eight PwPD (14 anxiety, 14 nonanxiety) participated in a 5-day weight-shifting study by coupling the bearing weight of their more-affected leg to a sinusoidal target at 0.25 Hz. We tested the weight-shifting control on day 1 (pretest), day 3 (posttest), and day 5 (retention test) with a learning session on day 3. The error and jerk of weight-shifting trajectory and the theta and gamma powers of electroencephalography in prefrontal, frontal, sensorimotor and parietal-occipital areas were measured. At the pretest, the anxiety group showed larger error and smaller jerk of weight-shifting with greater prefrontal theta, frontal gamma, and sensorimotor gamma powers than the nonanxiety group. Anxiety intensity was correlated positively with weight-shifting error and theta power but negatively with weight-shifting jerk. Reduced weight-shifting error with increased theta power after weight-shifting learning was observed in the nonanxiety group. However, the anxiety group showed decreased gamma power after weight-shifting learning without behavior change. Our findings suggest differential weight-shifting control and associated cortical activation between PwPD with and without anxiety. In addition, anxiety would deteriorate weight-shifting control and hinder weight-shifting learning benefits in PwPD, leading to less weight-shifting accuracy and correction.
焦虑和姿势控制缺陷可能与帕金森病患者（PwPD）有关。然而，焦虑水平与体重转移控制之间的关系仍不清楚。本研究旨在探讨：1）是否存在焦虑和非焦虑 PwPD 之间的体重转移控制存在差异；2）两种人群的体重转移学习效果是否存在差异。此外，我们评估了皮质活动，以研究体重转移控制的神经机制。28 名 PwPD（14 名焦虑，14 名非焦虑）通过将其受影响较大的腿部承重与 0.25 Hz 的正弦目标耦合，参与了为期 5 天的体重转移研究。我们在第 1 天（预测试）、第 3 天（后测试）和第 5 天（保留测试）进行了体重转移控制测试，并在第 3 天进行了学习会话。测量了体重转移轨迹的误差和冲击以及前额叶、额叶、感觉运动和顶枕叶区域的脑电图的θ和γ功率。在预测试中，与非焦虑组相比，焦虑组的体重转移轨迹误差较大，冲击较小，前额叶θ、额叶γ和感觉运动γ功率较大。焦虑强度与体重转移误差呈正相关，与体重转移冲击呈负相关。在非焦虑组中，在进行体重转移学习后，观察到体重转移误差减小，θ 功率增加。然而，在进行体重转移学习后，焦虑组的γ 功率减小，而行为没有改变。我们的研究结果表明，存在焦虑和非焦虑的 PwPD 之间的体重转移控制和相关皮质激活存在差异。此外，焦虑会恶化 PwPD 的体重转移控制，并阻碍体重转移学习的益处，导致体重转移准确性和校正能力降低。
