Effects of motor imagery training of Parkinson's disease: a protocol for a randomized clinical trial

Abstract Background Gait disorders in individuals with Parkinson’s disease (PD) may be associated with alterations in the motor control system and aggravated by psychoemotional and cognitive issues. Therapeutic strategies aimed at self-perception and motor regulation seem to be promising. Motor imagery (MI) has been shown to be one of these strategies, but there is still no clear evidence of its applicability in this population. The aim of this trial is to determine the effects of motor-imagery training on the gait and electroencephalographic activity of individuals with PD. Methods/design The sample will consist of 40 individuals, aged between 45 and 75 years, in the mild and moderate phase of the disease, with the ability to generate voluntary mental images. They will be assessed for cognitive level, degree of physical disability, mental-image clarity, kinematic gait variables, electroencephalographic activity and mobility. Next, subjects will be randomly assigned to an experimental group (EG) and a control group (CG). The EG will perform motor imagery and gait, while the CG will only engage in gait exercises. Twelve training sessions will be conducted lasting up to 90 min each, three times a week, for 4 weeks. The subjects will be reassessed on the kinematic variables of gait, electroencephalographic activity and mobility at 1, 7 and 30 days after the final training session. Discussion The results may provide an important advance in neurological rehabilitation where an easy-access and low-cost intervention may help to improve gait, electroencephalographic activity and mobility in individuals with PD. Trial registration Clinicaltrials.gov, ID: NCT03439800. Registered on 15 November 2017.

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Effects of motor imagery training of gait in Parkinson´s disease: a protocol for a randomized clinical trial

10.21203/rs.2.316/v1 ◽

2019 ◽

Author(s):

Isaíra Almeida Pereira da Silva Nascimento ◽

Lorenna Santiago ◽

Aline Alves De Souza ◽

Camila De Lima Pegado ◽

Tatiana Ribeiro ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Imagery ◽

Mental Image ◽

Training Session ◽

Gait Disorders ◽

Easy Access ◽

Control Group ◽

Imagery Training ◽

Electroencephalographic Activity

Abstract Background: Gait disorders in individuals with Parkinson’s Disease (PD) may be associated with alterations in the motor control system and aggravated by psychoemotional and cognitive issues. Therapeutic strategies aimed at self-perception and motor regulation seem to be promising. Motor imagery (MI) has been shown to be one of these strategies, but there is still no clear evidence of its applicability in this population. The aim of this trial is to determine the effects of motor imagery training on the gait and electroencephalographic activity of individuals with PD. Methods: The sample consisted of 40 individuals, aged between 45 and 75 years, in the mild and moderate phase of the disease, with the ability to generate voluntary mental images. They will be assessed for cognitive level, degree of physical disability, mental image clarity, kinematic gait variables, electroencephalographic activity and mobility. Next, subjects will be randomly assigned to an experimental (EG) and control group (CG). The EG will perform motor imagery and gait, while the CG will only engage in gait exercises. Twelve training sessions will be conducted lasting up to 90 minutes each, 3 times a week, for 4 weeks. They will be reassessed on the kinematic variables of gait, electroencephalographic activity and mobility, one, seven and thirty days after the final training session. Discussion: The results may provide an important advance in neurological rehabilitation. An easy-access and low-cost intervention may help improve gait, electroencephalographic activity and mobility in individuals with PD. Trial Registration: Clinicaltrials.gov: NCT03439800. Registered 15 November 2017. Keywords: Parkinson’s disease; Rehabilitation; Cerebral activation; Neurological gait disorders.

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Effects of motor imagery training of gait in Parkinson´s disease: a protocol for a randomized clinical trial

10.21203/rs.2.316/v2 ◽

2019 ◽

Author(s):

Isaíra Almeida Pereira da Silva Nascimento ◽

Lorenna Santiago ◽

Aline Alves De Souza ◽

Camila De Lima Pegado ◽

Tatiana Ribeiro ◽

...

Keyword(s):

Motor Imagery ◽

Low Cost ◽

Mental Image ◽

Training Session ◽

Easy Access ◽

Control Group ◽

Imagery Training ◽

Motor Control System ◽

And Control ◽

Electroencephalographic Activity

Abstract Background Gait disorders in individuals with Parkinson’s Disease (PD) may be associated with alterations in the motor control system and aggravated by psychoemotional and cognitive issues. Therapeutic strategies aimed at self-perception and motor regulation seem to be promising. Motor imagery (MI) has been shown to be one of these strategies, but there is still no clear evidence of its applicability in this population. The aim of this trial is to determine the effects of motor imagery training on the gait and electroencephalographic activity of individuals with PD. Methods/Design The sample consisted of 40 individuals, aged between 45 and 75 years, in the mild and moderate phase of the disease, with the ability to generate voluntary mental images. They will be assessed for cognitive level, degree of physical disability, mental image clarity, kinematic gait variables, electroencephalographic activity and mobility. Next, subjects will be randomly assigned to an experimental (EG) and control group (CG). The EG will perform motor imagery and gait, while the CG will only engage in gait exercises. Twelve training sessions will be conducted lasting up to 90 minutes each, 3 times a week, for 4 weeks. They will be reassessed on the kinematic variables of gait, electroencephalographic activity and mobility, one, seven and thirty days after the final training session. Discussion The results may provide an important advance in neurological rehabilitation. An easy-access and low-cost intervention may help improve gait, electroencephalographic activity and mobility in individuals with PD.

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Validation of quantitative gait analysis systems for Parkinson’s disease for use in supervised and unsupervised environments

BMC Neurology ◽

10.1186/s12883-021-02354-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sara Alberto ◽

Sílvia Cabral ◽

João Proença ◽

Filipa Pona-Ferreira ◽

Mariana Leitão ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Gait Analysis ◽

Inertial Sensor ◽

Low Cost ◽

Wearable Sensors ◽

Smartphone Application ◽

Control Group ◽

Wearable Systems ◽

Full Body

Abstract Background Gait impairments are among the most common and impactful symptoms of Parkinson’s disease (PD). Recent technological advances aim to quantify these impairments using low-cost wearable systems for use in either supervised clinical consultations or long-term unsupervised monitoring of gait in ecological environments. However, very few of these wearable systems have been validated comparatively to a criterion of established validity. Objective We developed two movement analysis solutions (3D full-body kinematics based on inertial sensors, and a smartphone application) in which validity was assessed versus the optoelectronic criterion in a population of PD patients. Methods Nineteen subjects with PD (7 female) participated in the study (age: 62 ± 12.27 years; disease duration: 6.39 ± 3.70 years; HY: 2 ± 0.23). Each participant underwent a gait analysis whilst barefoot, at a self-selected speed, for a distance of 3 times 10 m in a straight line, assessed simultaneously with all three systems. Results Our results show excellent agreement between either solution and the optoelectronic criterion. Both systems differentiate between PD patients and healthy controls, and between PD patients in ON or OFF medication states (normal difference distributions pooled from published research in PD patients in ON and OFF states that included an age-matched healthy control group). Fair to high waveform similarity and mean absolute errors below the mean relative orientation accuracy of the equipment were found when comparing the angular kinematics between the full-body inertial sensor-based system and the optoelectronic criterion. Conclusions We conclude that the presented solutions produce accurate results and can capture clinically relevant parameters using commodity wearable sensors or a simple smartphone. This validation will hopefully enable the adoption of these systems for supervised and unsupervised gait analysis in clinical practice and clinical trials.

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Study of cognitive impairment and genetic polymorphism of SLC41A1 (rs11240569 allele) in Parkinson’s disease in Upper Egypt: case-control study

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-021-00341-0 ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Hamdy N. El-Tallawy ◽

Tahia H. Saleem ◽

Wafaa M. Farghaly ◽

Heba Mohamed Saad Eldien ◽

Ashraf Khodaery ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Case Control Study ◽

Case Control ◽

Control Group ◽

Motor Symptoms ◽

And Control ◽

Non Motor Symptoms ◽

Control Study

Abstract Background Parkinson’s disease is one of the neurodegenerative disorders that is caused by genetic and environmental factors or interaction between them. Solute carrier family 41 member 1 within the PARK16 locus has been reported to be associated with Parkinson’s disease. Cognitive impairment is one of the non-motor symptoms that is considered a challenge in Parkinson’s disease patients. This study aimed to investigate the association of rs11240569 polymorphism; a synonymous coding variant in SLC41A1 in Parkinson’s disease patients in addition to the assessment of cognitive impairment in those patients. Results In a case -control study, rs11240569 single nucleotide polymorphisms in SLC41A1, genes were genotyped in 48 Parkinson’s disease patients and 48 controls. Motor and non-motor performance in Parkinson's disease patients were assessed by using the Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). The genotype and allele frequencies were compared between the two groups and revealed no significant differences between case and control groups for rs11240569 in SLC41A1 gene with P value .523 and .54, respectively. Cognition was evaluated and showed the mean ± standard deviation (SD) of WAIS score of PD patients 80.4 ± 9.13 and the range was from 61 to 105, in addition to MMSE that showed mean ± SD 21.96 ± 3.8. Conclusion Genetic testing of the present study showed that rs11240569 polymorphism of SLC41A1 gene has no significant differences in distributions of alleles and genotypes between cases and control group, in addition to cognitive impairment that is present in a large proportion of PD patients and in addition to the strong correlation between cognitive impairment and motor and non-motor symptoms progression.

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Donepezil for mild cognitive impairment in Parkinson’s disease

Scientific Reports ◽

10.1038/s41598-021-84243-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kyoungwon Baik ◽

Seon Myeong Kim ◽

Jin Ho Jung ◽

Yang Hyun Lee ◽

Seok Jong Chung ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Treatment Group ◽

Outcome Measures ◽

Rating Scale ◽

Secondary Outcome ◽

Control Group ◽

Significant Difference

AbstractWe investigated the efficacy of donepezil for mild cognitive impairment in Parkinson’s disease (PD-MCI). This was a prospective, non-randomized, open-label, two-arm study. Eighty PD-MCI patients were assigned to either a treatment or control group. The treatment group received donepezil for 48 weeks. The primary outcome measures were the Korean version of Mini-Mental State Exam and Montreal Cognitive Assessment scores. Secondary outcome measures were the Clinical Dementia Rating, Unified Parkinson’s Disease Rating Scale part III, Clinical Global Impression scores. Progression of dementia was assessed at 48-week. Comprehensive neuropsychological tests and electroencephalography (EEG) were performed at baseline and after 48 weeks. The spectral power ratio of the theta to beta2 band (TB2R) in the electroencephalogram was analyzed. There was no significant difference in the primary and secondary outcome measures between the two groups. However, the treatment group showed a significant decrease in TB2R at bilateral frontotemporoparietal channels compared to the control group. Although we could not demonstrate improvements in the cognitive functions, donepezil treatment had a modulatory effect on the EEG in PD-MCI patients. EEG might be a sensitive biomarker for detecting changes in PD-MCI after donepezil treatment.

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Integrated network analysis identifying potential novel drug candidates and targets for Parkinson's disease

Scientific Reports ◽

10.1038/s41598-021-92701-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Pusheng Quan ◽

Kai Wang ◽

Shi Yan ◽

Shirong Wen ◽

Chengqun Wei ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Drug Target ◽

Target Genes ◽

Enrichment Analysis ◽

Gene Set Enrichment Analysis ◽

Functional Enrichment ◽

Control Group ◽

Drug Candidates ◽

Novel Drug

AbstractThis study aimed to identify potential novel drug candidates and targets for Parkinson’s disease. First, 970 genes that have been reported to be related to PD were collected from five databases, and functional enrichment analysis of these genes was conducted to investigate their potential mechanisms. Then, we collected drugs and related targets from DrugBank, narrowed the list by proximity scores and Inverted Gene Set Enrichment analysis of drug targets, and identified potential drug candidates for PD treatment. Finally, we compared the expression distribution of the candidate drug-target genes between the PD group and the control group in the public dataset with the largest sample size (GSE99039) in Gene Expression Omnibus. Ten drugs with an FDR < 0.1 and their corresponding targets were identified. Some target genes of the ten drugs significantly overlapped with PD-related genes or already known therapeutic targets for PD. Nine differentially expressed drug-target genes with p < 0.05 were screened. This work will facilitate further research into the possible efficacy of new drugs for PD and will provide valuable clues for drug design.

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PETTLEP imagery and tennis service performance: an applied investigation

Journal of Imagery Research in Sport and Physical Activity ◽

10.1515/jirspa-2019-0013 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Nafih Cherappurath ◽

Masilamani Elayaraja ◽

Dilshith A. Kabeer ◽

Amila Anjum ◽

Paris Vogazianos ◽

...

Keyword(s):

Age Groups ◽

Training Session ◽

Performance Outcomes ◽

Service Performance ◽

Control Group ◽

Specific Training ◽

Tennis Players ◽

Imagery Training ◽

Before And After ◽

Junior Tennis

AbstractTennis is one of the most popular and widely played sports enjoyed by players of different age groups and genders as a profession as well as a mode of recreation. A novel method, PETTLEP imagery combines both conventional and non-conventional style of training of an athlete and improves one’s performance. This study aimed to analyze the tennis service performance of junior tennis players based on PETTLEP imagery training. Forty-four junior male tennis players (Mage=13.22 years, SD=0.42) were selected for the study. The investigator handed over the MIQ-R questionnaire to all the participants in which they scored 16 and above points as per previous research. The participants were equally divided (n=11) into three experimental groups (E1, E2, and E3) and a control group. The service performance outcomes of all the players were compared before and after a training session. The three experimental groups were assigned with service-specific training, service-specific training combined with PETTLEP imagery training, and PETTLEP imagery training alone, respectively, for three days per week for 12 weeks. They were tested on their service accuracy based on the International tennis number (ITN) manual on-court assessment test. The data were assessed for normality and analyzed using non-parametric methods to reveal main effects (each training method alone) as well as to calculate the combined effect of PETTLEP and service-specific training. Certain significant improvements in tennis service were observed with service-specific training alone. Though it marginally outperformed the PETTLEP imagery method, the most improved services were observed with both PETTLEP and service-specific training utilized together. This implies an additive effect when both methods are used together.

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Validation of Cognitive Rehabilitation as a Balance Rehabilitation Strategy in Patients with Parkinson’s Disease: Study Protocol for a Randomized Controlled Trial

Medicina ◽

10.3390/medicina57040314 ◽

2021 ◽

Vol 57 (4) ◽

pp. 314

Author(s):

Aida Arroyo-Ferrer ◽

Francisco José Sánchez-Cuesta ◽

Yeray González-Zamorano ◽

María Dolores del Castillo ◽

Carolina Sastre-Barrios ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Therapy ◽

Cognitive Processing ◽

Processing Speed ◽

Cognitive Rehabilitation ◽

Neurodegenerative Disorder ◽

Control Group ◽

Motor Symptoms ◽

The Impact

Background: Parkinson’s disease (PD) is the second most common neurodegenerative disorder. This disease is characterized by motor symptoms, such as bradykinesia, tremor, and rigidity. Although balance impairment is characteristic of advanced stages, it can be present with less intensity since the beginning of the disease. Approximately 60% of PD patients fall once a year and 40% recurrently. On the other hand, cognitive symptoms affect up to 20% of patients with PD in early stages and can even precede the onset of motor symptoms. There are cognitive requirements for balance and can be challenged when attention is diverted or reduced, linking a worse balance and a higher probability of falls with a slower cognitive processing speed and attentional problems. Cognitive rehabilitation of attention and processing speed can lead to an improvement in postural stability in patients with Parkinson’s. Methods: We present a parallel and controlled randomized clinical trial (RCT) to assess the impact on balance of a protocol based on cognitive rehabilitation focused on sustained attention through the NeuronUP platform (Neuronup SI, La Rioja, Spain) in patients with PD. For 4 weeks, patients in the experimental group will receive cognitive therapy three days a week while the control group will not receive any therapy. The protocol has been registered at trials.gov NCT04730466. Conclusions: Cognitive therapy efficacy on balance improvement may open the possibility of new rehabilitation strategies for prevention of falls in PD, reducing morbidity, and saving costs to the health care system.

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Feasibility Aspects of Exploring Exercise-Induced Neuroplasticity in Parkinson’s Disease: A Pilot Randomized Controlled Trial

Parkinson s Disease ◽

10.1155/2020/2410863 ◽

2020 ◽

Vol 2020 ◽

pp. 1-12 ◽

Cited By ~ 1

Author(s):

Hanna Johansson ◽

Malin Freidle ◽

Urban Ekman ◽

Ellika Schalling ◽

Breiffni Leavy ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dual Task ◽

Trial Design ◽

Controlled Trial ◽

Recruitment Rate ◽

Blood Sampling ◽

Assessment Process ◽

Control Group ◽

Exercise Induced

Background. Recent studies indicate that exercise can induce neuroplastic changes in people with Parkinson’s disease (PwPD). Reports of feasibility outcomes from existing pilot trials however are, of date, insufficient to enable replication by others in larger definitive trials. Objective. To evaluate trial design for a definitive trial by exploring process and scientific feasibility. Methods. The trial design was a parallel-group RCT pilot with a 1 : 1 allocation ratio to either HiBalance or an active control group (HiCommunication). Both groups received one-hour sessions twice weekly, plus home exercises weekly, for 10 weeks. Participants with mild-to-moderate Parkinson’s disease (PD) were recruited via advertisement. Assessment included physical performance, structural and functional MRI, blood sampling, neuropsychological assessment, and speech/voice assessment. Process and scientific feasibility were monitored throughout the study. Process feasibility involved recruitment, participant acceptability of assessments and interventions, assessment procedures (focus on imaging, blood sampling, and dual-task gait analysis), and blinding procedures. Scientific feasibility involved trends in outcome response and safety during group training and home exercises. Data are presented in median, minimum, and maximum values. Changes from pre- to postintervention are reported descriptively. Results. Thirteen participants were included (4 women, mean age 69.7 years), with a recruitment rate of 31%. Attendance rates and follow-up questionnaires indicated that both groups were acceptable to participate. Image quality was acceptable; however, diplopia and/or sleepiness were observed in several participants during MRI. With regard to dual-task gait performance, there appeared to be a ceiling effect of the cognitive tasks with seven participants scoring all correct answers at pretest. Blinding of group allocation was successful for one assessor but was broken for half of participants for the other. Conclusions. The overall trial design proved feasible to perform, but further strengthening ahead of the definitive RCT is recommended, specifically with respect to MRI setup, cognitive dual-tasks during gait, and blinding procedures. This trial is registered with NCT03213873.

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