Jazaeri Seyede Zohreh, Joghataei Mohammad Taghi, Jamali Akram, Montazeri Hamed, Taghizadeh Ghorban
Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.
Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.
Sci Rep. 2025 Aug 30;15(1):31949. doi: 10.1038/s41598-025-15161-y.
Aquaporin-4 (AQP4), a modulator of motor symptoms and synaptic plasticity, may contribute to freezing of gait (FOG)-a significant gait disturbance in Parkinson's disease with an unclear pathophysiology-and its associated impairments in balance learning. However, this potential relationship has not been investigated until now. This preliminary study explores the potential role of AQP4 in FOG and its associated balance learning deficits. The study involved fifteen patients with FOG, fifteen patients without FOG, and fifteen healthy controls. Serum AQP4 levels were measured using enzyme-linked immunosorbent assay, and balance learning was assessed using a voluntary dynamic balance task performed on a stabilometer. Notably, patients who were FOG-positive exhibited significantly higher serum AQP4 levels compared to the other two groups (p < 0.001). These elevated levels showed a positive correlation with FOG severity (ρ = 0.51, p = 0.004). Furthermore, the serum AQP4 levels were inversely correlated with both the slope (ρ = -0.65, p < 0.001) and rate (ρ = -0.46, p = 0.01) of balance learning in PwPD. FOG-positive individuals exhibited impaired voluntary balance learning compared to both FOG-negative and healthy participants. FOG-negative participants showed initial improvement, while healthy individuals demonstrated continuous enhancement across consecutive learning blocks (the first significant main effect of time on balance performance, comparing Blocks 1 and 2, was p = 0.02 for FOG-negative and p = 0.03 for healthy groups), with both groups maintaining their acquired skills over time. These findings suggest that AQP4 may play a significant role in FOG and its associated learning impairments, warranting further investigation for potential treatments. Additionally, alternative balance learning protocols may be necessary for FOG-positive patients.
水通道蛋白4(AQP4)是运动症状和突触可塑性的调节因子,可能导致冻结步态(FOG)——帕金森病中一种重要的步态障碍,其病理生理学尚不清楚——及其相关的平衡学习障碍。然而,这种潜在关系至今尚未得到研究。这项初步研究探讨了AQP4在FOG及其相关平衡学习缺陷中的潜在作用。该研究纳入了15名有FOG的患者、15名无FOG的患者和15名健康对照者。采用酶联免疫吸附测定法测量血清AQP4水平,并使用在稳定仪上进行的自愿动态平衡任务评估平衡学习情况。值得注意的是,与其他两组相比,FOG阳性患者的血清AQP4水平显著更高(p < 0.001)。这些升高的水平与FOG严重程度呈正相关(ρ = 0.51,p = 0.004)。此外,帕金森病患者血清AQP4水平与平衡学习的斜率(ρ = -0.65,p < 0.001)和速率(ρ = -0.46,p = 0.01)均呈负相关。与FOG阴性和健康参与者相比,FOG阳性个体的自愿平衡学习受损。FOG阴性参与者最初有改善,而健康个体在连续的学习阶段表现出持续增强(时间对平衡表现的第一个显著主要效应,比较第1组和第2组,FOG阴性组为p = 0.02,健康组为p = 0.03),两组随着时间推移都保持了所获得的技能。这些发现表明,AQP4可能在FOG及其相关学习障碍中起重要作用,值得进一步研究潜在的治疗方法。此外,对于FOG阳性患者可能需要替代的平衡学习方案。
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