Effects of Acupuncture Treatment on Functional Brain Networks of Parkinson’s Disease Patients during Treadmill Walking: An fNIRS Study

Acupuncture is increasingly being used as an alternative treatment for patients with Parkinson’s disease (PD). We aimed to evaluate the effects of acupuncture on gait-related brain function in patients with PD using functional near-infrared spectroscopy (fNIRS). Twenty-four patients with PD were randomly assigned to intervention (acupuncture twice a week for 4 weeks) or control (non-treatment) groups. fNIRS experiments applying a block design were performed at baseline (0 weeks) and 4- and 8-week follow-up and cortical activation and connectivity were evaluated. After acupuncture treatment, oxy-hemoglobin (HbO) levels in the intervention group were significantly increased in the primary motor cortex (M1), supplementary motor area (SMA), and prefrontal cortex (PFC). Furthermore, following acupuncture treatment in the intervention group, the connectivities in the M1 and PFC regions increased. The results show that acupuncture may be a useful complementary treatment for gait disturbances in patients with PD, and fNIRS can be applicable to evaluate neural plasticity directly. The evaluation method in this paper can be used to assess the neural plasticity related to various rehabilitation techniques.

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Is Cortical Activation During Walking Different Between Parkinson’s Disease Motor Subtypes?

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa174 ◽

2020 ◽

Author(s):

Diego Orcioli-Silva ◽

Rodrigo Vitório ◽

Victor Spiandor Beretta ◽

Núbia Ribeiro da Conceição ◽

Priscila Nóbrega-Sousa ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Obstacle Avoidance ◽

Primary Motor Cortex ◽

Cortical Activity ◽

Postural Instability ◽

Cortical Activation ◽

Motor Area ◽

Gait Disorder ◽

Beta Power

Abstract Parkinson’s disease (PD) is often classified into tremor dominant (TD) and postural instability gait disorder (PIGD) subtypes. Degeneration of subcortical/cortical pathways is different between PD subtypes, which leads to differences in motor behavior. However, the influence of PD subtype on cortical activity during walking remains poorly understood. Therefore, we aimed to investigate the influence of PD motor subtypes on cortical activity during unobstructed walking and obstacle avoidance. Seventeen PIGD and 19 TD patients performed unobstructed walking and obstacle avoidance conditions. Brain activity was measured using a mobile functional near-infrared spectroscopy–electroencephalography (EEG) systems, and gait parameters were analyzed using an electronic carpet. Concentrations of oxygenated hemoglobin (HbO2) of the prefrontal cortex (PFC) and EEG absolute power from alpha, beta, and gamma bands in FCz, Cz, CPz, and Oz channels were calculated. These EEG channels correspond to supplementary motor area, primary motor cortex, posterior parietal cortex, and visual cortex, respectively. Postural instability gait disorder patients presented higher PFC activity than TD patients, regardless of the walking condition. Tremor dominant patients presented reduced beta power in the Cz channel during obstacle avoidance compared to unobstructed walking. Both TD and PIGD patients decreased alpha and beta power in the FCz and CPz channels. In conclusion, PIGD patients need to recruit additional cognitive resources from the PFC for walking. Both TD and PIGD patients presented changes in the activation of brain areas related to motor/sensorimotor areas in order to maintain balance control during obstacle avoidance, being that TD patients presented further changes in the motor area (Cz channel) to avoid obstacles.

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People With Parkinson’s Disease Exhibit Reduced Cognitive and Motor Cortical Activity When Undertaking Complex Stepping Tasks Requiring Inhibitory Control

Neurorehabilitation and Neural Repair ◽

10.1177/1545968320969943 ◽

2020 ◽

Vol 34 (12) ◽

pp. 1088-1098

Author(s):

Paulo H. S. Pelicioni ◽

Stephen R. Lord ◽

Yoshiro Okubo ◽

Daina L. Sturnieks ◽

Jasmine C. Menant

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Inhibitory Control ◽

Near Infrared ◽

Premotor Cortex ◽

Cortical Activity ◽

Cortical Activation ◽

Functional Near Infrared Spectroscopy ◽

Dorsolateral Prefrontal ◽

Motor Cortical

Background People with Parkinson’s disease (PD) have difficulties generating quick and accurate steps in anticipation of and/or in response to environmental hazards. However, neural mechanisms underlying performance in cognitively demanding stepping tasks are unclear. Objective This study compared activation patterns in cognitive and motor cortical regions using functional near-infrared spectroscopy (fNIRS) between people with PD and age-matched healthy older adults (HOA) during stepping tasks. Methods Fifty-two people with PD and 95 HOA performed a simple choice stepping reaction time test (CSRT) and 2 cognitively demanding stepping tests (inhibitory CSRT [iCSRT] and Stroop stepping test [SST]) on a computerized step mat. Cortical activation in the dorsolateral prefrontal cortex (DLPFC), Broca’s area, supplementary motor area (SMA), and premotor cortex (PMC) were recorded using fNIRS. Stepping performance and cortical activity were contrasted between groups and between the CSRT and the iCSRT and SST. Results The PD group performed worse than the HOA in all 3 stepping tests. A consistent pattern of interactions indicated differential hemodynamic responses between the groups. Compared with the CSRT, the PD group exhibited reduced DLPFC activity in the iCSRT and reduced SMA and PMC activity in the SST. The HOA exhibited increased DLPFC, SMA, and PMC activity when performing the SST in comparison with the CSRT task. Conclusions In contrast to the HOA, the PD group demonstrated reduced cortical activity in the DLPFC, SMA, and PMC during the more complex stepping tasks requiring inhibitory control. This may reflect subcortical and/or multiple pathway damage with subsequent deficient use of cognitive and motor resources.

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Cerebral Hemodynamic Responses to the Difficulty Level of Ambulatory Tasks in Patients With Parkinson’s Disease: A Systematic Review and Meta-Analysis

Neurorehabilitation and Neural Repair ◽

10.1177/15459683211028548 ◽

2021 ◽

pp. 154596832110285

Author(s):

Jin P. Lin ◽

Hong S. Feng ◽

Hua Zhai ◽

Xia Shen

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Near Infrared ◽

Cognitive Status ◽

Cortical Activation ◽

Difficulty Level ◽

Hemodynamic Responses ◽

Functional Near Infrared Spectroscopy ◽

Cerebral Hemodynamic ◽

Healthy Elderly

Background. Ambulatory tasks are the important components of balance training which effectively improve postural stability and functional activities in persons with Parkinson’s disease (PD). The difficulty level of an ambulatory task is usually set in the form of attention, direction, speed, or amplitude requirement. Objectives. This study aimed to explore the neural mechanisms of cerebral hemodynamic responses to the difficulty level of ambulatory tasks in persons with PD. Methods. We included ten studies that examined cerebral hemodynamic responses during ambulatory tasks at different difficulty levels in persons with PD. The change in hemodynamic responses was synthesized and meta-analyzed. Results. Patients during “ON” medication had higher relative change in oxygenated hemoglobin (ΔHBO2) in the prefrontal cortex in response to difficulty levels of ambulatory tasks, which is comparable to that in healthy elderly individuals. However, patients during “OFF” medication did not show cortical activation in response to difficulty levels. During the lower-difficulty tasks, patients during “ON” medication demonstrated higher ΔHBO2 than healthy elderly participants and patients during “OFF” medication. Factors found to significantly contribute to the heterogeneity across studies included subjects’ type and cognitive status, task duration, setting, and filter used for functional near-infrared spectroscopy (fNIRS) data pre-processing. Conclusions. The findings suggest that ambulatory task at a higher difficulty level could be necessary to train the cortical capacity of PD persons, which should be conducted during “ON” medication; meanwhile, the contributing factors to the heterogeneity of studies would be useful as a reference when designing comparable fNIRS studies.

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Gait Disturbance Improvement and Cerebral Cortex Rearrangement by Acupuncture in Parkinson’s Disease: A Pilot Assessor-Blinded, Randomized, Controlled, Parallel-Group Trial

Neurorehabilitation and Neural Repair ◽

10.1177/1545968320969942 ◽

2020 ◽

Vol 34 (12) ◽

pp. 1111-1123

Author(s):

Jung-Hee Jang ◽

Sangsoo Park ◽

Jinung An ◽

Jong-duk Choi ◽

In chan Seol ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cerebral Cortex ◽

Conventional Therapy ◽

Near Infrared ◽

Rating Scale ◽

Intervention Group ◽

Gait Disturbance ◽

Control Group ◽

Functional Near Infrared Spectroscopy

Background Parkinson’s disease (PD) leads to impaired mobility and limited independence. Objective We investigated the effects of acupuncture on gait disturbance and analyzed hemodynamic changes caused by acupuncture in the cerebral cortex of patients with PD. Methods Participants (n = 26) with gait disturbance due to PD were randomly assigned to the intervention (acupuncture twice a week for 4 weeks + conventional therapy) or control (conventional therapy) groups. We analyzed gait parameters using the GAITRite system and hemodynamic responses in the cerebral cortices using functional near-infrared spectroscopy, Unified Parkinson’s Disease Rating Scale (UPDRS) scores, neurotransmitter levels, as well as the immediate effects of acupuncture in patients with PD. Results The participants tended to walk with hypometric gait (high cadence, short steps) overground. After acupuncture treatment, those in the intervention group showed a significant reduction in cadence and the UPDRS scores involving “walking and balance” compared with those in the control group ( P = .004 and P = .020, respectively); the stride, swing, and single support times were significantly increased ( P = .006, P = .001, and P = .001, respectively). Oxyhemoglobin levels in the intervention group while walking on a treadmill were significantly increased in the prefrontal and supplementary motor areas. The oxyhemoglobin levels in the prefrontal cortex and swing time revealed significant positive correlations. Conclusions Our findings indicated that acupuncture tended to improve hypometric gait and rearranged activation of the cerebral cortex. Thus, acupuncture may be a useful complementary treatment for gait disturbance, including hypometric gait, in patients with PD. Trial Registration Number. Clinical Research Information Service (KCT0002603), https://cris.nih.go.kr/cris/index.jsp

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Changes in Sensorimotor Cortical Activation in Children Using Prostheses and Prosthetic Simulators

Brain Sciences ◽

10.3390/brainsci11080991 ◽

2021 ◽

Vol 11 (8) ◽

pp. 991

Author(s):

Christopher Copeland ◽

Mukul Mukherjee ◽

Yingying Wang ◽

Kaitlin Fraser ◽

Jorge M. Zuniga

Keyword(s):

Near Infrared ◽

Primary Motor Cortex ◽

Tactile Feedback ◽

Cortical Activation ◽

Typically Developing ◽

Neural Responses ◽

Motor Tasks ◽

Functional Near Infrared Spectroscopy ◽

Limb Reduction ◽

Motor Dexterity

This study aimed to examine the neural responses of children using prostheses and prosthetic simulators to better elucidate the emulation abilities of the simulators. We utilized functional near-infrared spectroscopy (fNIRS) to evaluate the neural response in five children with a congenital upper limb reduction (ULR) using a body-powered prosthesis to complete a 60 s gross motor dexterity task. The ULR group was matched with five typically developing children (TD) using their non-preferred hand and a prosthetic simulator on the same hand. The ULR group had lower activation within the primary motor cortex (M1) and supplementary motor area (SMA) compared to the TD group, but nonsignificant differences in the primary somatosensory area (S1). Compared to using their non-preferred hand, the TD group exhibited significantly higher action in S1 when using the simulator, but nonsignificant differences in M1 and SMA. The non-significant differences in S1 activation between groups and the increased activation evoked by the simulator’s use may suggest rapid changes in feedback prioritization during tool use. We suggest that prosthetic simulators may elicit increased reliance on proprioceptive and tactile feedback during motor tasks. This knowledge may help to develop future prosthesis rehabilitative training or the improvement of tool-based skills.

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Enhanced Synchrony among Primary Motor Cortex Neurons in the 1-Methyl-4-Phenyl-1,2,3,6-Tetrahydropyridine Primate Model of Parkinson's Disease

Journal of Neuroscience ◽

10.1523/jneurosci.22-11-04639.2002 ◽

2002 ◽

Vol 22 (11) ◽

pp. 4639-4653 ◽

Cited By ~ 164

Author(s):

Joshua A. Goldberg ◽

Thomas Boraud ◽

Sharon Maraton ◽

Suzanne N. Haber ◽

Eilon Vaadia ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Cortex ◽

Primary Motor Cortex ◽

Primate Model

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Lack of LTP-like plasticity in primary motor cortex in Parkinson's disease

Experimental Neurology ◽

10.1016/j.expneurol.2010.11.020 ◽

2011 ◽

Vol 227 (2) ◽

pp. 296-301 ◽

Cited By ~ 70

Author(s):

A. Suppa ◽

L. Marsili ◽

D. Belvisi ◽

A. Conte ◽

E. Iezzi ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Cortex ◽

Primary Motor Cortex

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Acute dopamine boost has a negative effect on plasticity of the primary motor cortex in advanced Parkinson's disease

Brain ◽

10.1093/brain/aws124 ◽

2012 ◽

Vol 135 (7) ◽

pp. 2074-2088 ◽

Cited By ~ 44

Author(s):

A. Kishore ◽

T. Popa ◽

B. Velayudhan ◽

T. Joseph ◽

A. Balachandran ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Cortex ◽

Primary Motor Cortex ◽

Advanced Parkinson’S Disease ◽

Negative Effect

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Symptom-specific differential motor network modulation by deep brain stimulation in Parkinson’s disease

Journal of Neurosurgery ◽

10.3171/2020.10.jns202277 ◽

2021 ◽

pp. 1-9

Author(s):

William S. Gibson ◽

Aaron E. Rusheen ◽

Yoonbae Oh ◽

Myung-Ho In ◽

Krzysztof R. Gorny ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Deep Brain Stimulation ◽

Adverse Effects ◽

Primary Motor Cortex ◽

Blood Oxygen Level Dependent ◽

Blood Oxygen ◽

Oxygen Level ◽

Blood Oxygen Level ◽

Deep Brain

OBJECTIVE Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an established neurosurgical treatment for the motor symptoms of Parkinson’s disease (PD). While often highly effective, DBS does not always yield optimal therapeutic outcomes, and stimulation-induced adverse effects, including paresthesia, muscle contractions, and nausea/lightheadedness, commonly occur and can limit the efficacy of stimulation. Currently, objective metrics do not exist for monitoring neural changes associated with stimulation-induced therapeutic and adverse effects. METHODS In the present study, the authors combined intraoperative functional MRI (fMRI) with STN DBS in 20 patients with PD to test the hypothesis that stimulation-induced blood oxygen level–dependent signals contained predictive information concerning the therapeutic and adverse effects of stimulation. RESULTS As expected, DBS resulted in blood oxygen level–dependent activation in myriad motor regions, including the primary motor cortex, caudate, putamen, thalamus, midbrain, and cerebellum. Across the patients, DBS-induced improvements in contralateral Unified Parkinson’s Disease Rating Scale tremor subscores correlated with activation of thalamic, brainstem, and cerebellar regions. In addition, improvements in rigidity and bradykinesia subscores correlated with activation of the primary motor cortex. Finally, activation of specific sensorimotor-related subregions correlated with the presence of DBS-induced adverse effects, including paresthesia and nausea (cerebellar cortex, sensorimotor cortex) and unwanted muscle contractions (caudate and putamen). CONCLUSIONS These results suggest that DBS-induced activation patterns revealed by fMRI contain predictive information with respect to the therapeutic and adverse effects of DBS. The use of fMRI in combination with DBS therefore may hold translational potential to guide and improve clinical stimulator optimization in patients.

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