Exploring the Relationship Between Sleep Quality, Sleep-Related Biomarkers, and Motor Skill Acquisition Using Virtual Reality in People With Parkinson's Disease: A Pilot Study

Background and Objectives: Despite the fact that sleep disturbances are among the most common and disabling manifestations of Parkinson's disease (PD), no study has investigated the effect of sleep quality and sleep-related biomarkers on motor skill acquisition in people with Parkinson's disease (PwPD).Objective: To examine the relationship between skill acquisition, sleep quality, and sleep-related biomarkers in PwPD using virtual reality (VR) system.Methods: This is a cross sectional study conducted on 31 PwPD and 31 healthy controls. To assess skill acquisition, each participant practiced a VR game 6 times (blocks). The main outcomes from the VR game were the required time to complete the VR game and the recorded errors. Motor skill acquisition was calculated as the difference of scores between block 6 and block 2 for both outcomes. Sleep was assessed subjectively using Pittsburgh Sleep Quality Index (PSQI) and objectively using the Actisleep. To assess sleep related biomarker, plasma serotonin level was examined.Results: PwPD and healthy controls demonstrated a practice-related improvement in performance as shown by the main effect of block for each of the VR outcome measures (p < 0.000, time required to complete VR game; p < 0.000, recorded errors). There was no interaction effect between Block X Group for both outcome measures. There were significant correlations in both groups (p < 0.05) between motor skill acquisition (as indicated by the difference of time required to complete the VR game between block 6 and block 2) and PSQI total score, wake after sleep onset, and sleep efficiency. Additionally, a significant correlation was observed in both groups between motor skill acquisition (as indicated by the difference of time required to complete the VR game between block 6 and block 2) and the plasma serotonin level (p < 0.05). These correlations in PwPD remained significant, even after adjusting for disease motor severity, cognitive status, depression, and daily dose of L-dopa.Discussion and Conclusions: Sleep quality may influence motor skill acquisition in PwPD. Healthcare professionals are encouraged to be aware about sleep quality and sleep assessment tools. Therapies may target improving sleep quality which could result in improving motor skill acquisition.

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Impaired Motor Skill Acquisition Using Mirror Visual Feedback Improved by Transcranial Direct Current Stimulation (tDCS) in Patients With Parkinson’s Disease

Frontiers in Neuroscience ◽

10.3389/fnins.2019.00602 ◽

2019 ◽

Vol 13 ◽

Cited By ~ 5

Author(s):

Mitsuya Horiba ◽

Yoshino Ueki ◽

Ippei Nojima ◽

Yoko Shimizu ◽

Kento Sahashi ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Skill Acquisition ◽

Visual Feedback ◽

Direct Current ◽

Motor Skill ◽

Transcranial Direct Current Stimulation ◽

Direct Current Stimulation ◽

Motor Skill Acquisition ◽

Mirror Visual Feedback

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The Relationship between Sleep Quality, Sleep-Related Biomarkers and Motor Skill Acquisition in People with Multiple Sclerosis: A Pilot Study

Physical Therapy ◽

10.1093/ptj/pzab175 ◽

2021 ◽

Author(s):

Alham Al-Sharman ◽

Heba Mefleh Al-khazaaleh ◽

Hanan Khalil ◽

Ala’ S Aburub ◽

Khalid El-Salem

Keyword(s):

Multiple Sclerosis ◽

Sleep Quality ◽

Motor Skills ◽

Skill Acquisition ◽

Negative Correlation ◽

Motor Skill ◽

Significant Negative Correlation ◽

Enzyme Linked Immunosorbent Assay ◽

Serotonin Level ◽

Motor Skill Acquisition

Abstract Objective Neurorehabilitation that involves learning new motor skills is one of the promising clinical methods for motor recovery in people with multiple sclerosis (PwMS); therefore, factors that influence the acquisition of motor skills in PwMS need to be investigated. Sleep disturbances are common in PwMS; however, no study has investigated the effect of sleep and sleep-related biomarkers on skill acquisition in PwMS. This study aimed to examine the effect of sleep and sleep-related biomarkers on motor acquisition in PwMS. Methods Forty participants with MS and 40 controls were recruited in this study. To assess motor acquisition, each participant was asked to perform a novel game through a virtual reality (VR) system 5 times (blocks). The main outcome measures for each block were the required time to complete the VR game and the recorded errors. The difference in scores between block 5 and block 1 for both outcomes was considered to represent motor skill acquisition. Sleep was assessed by self-report using the Pittsburgh Sleep Quality Index (PSQI) and objectively using sleep monitor technology. Serotonin level was assessed using means of enzyme-linked immunosorbent assay (ELISA) using plasma samples. Results There were significant positive correlations in both groups between motor skill acquisition and PSQI score. In PwMS, significant negative correlation between motor skill acquisition and sleep efficiency and significant positive correlation between motor skill acquisition and sleep latency were also observed. Interestingly, a significant negative correlation was observed between motor skill acquisition and the plasma serotonin level in both groups. Most of these correlations remained significant after controlling for disease severity, fatigue, baseline performance, and cognitive status. Conclusions Sleep quality may influence motor skill acquisition in PwMS. Circulatory serotonin level might explain this relationship. Impact Physical therapists are encouraged to be aware of sleep quality and sleep assessment. Sleep management strategies should be considered when treating PwMS.

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