Effects of rTMS and intensive rehabilitation in Parkinson's Disease on learning and retention.
Effects of rTMS and intensive rehabilitation in Parkinson's Disease on learning and retention.
复制标题
rTMS 和帕金森病强化康复对学习和记忆力的影响。
DOI：
10.1109/icorr.2019.8779471
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Ghilardi,MFelice
中科院分区：
文献类型：
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作者：
Marchesi,Giorgia;Albanese,GiuliaAurora;Ferrazzoli,Davide;George,Shaina;Ricci,Serena;Tatti,Elisa;DiRocco,Alessandro;Quartarone,Angelo;Frazzitta,Giuseppe;Ghilardi,MFelice
运动伴随着在感觉运动区的不同范围内的振荡活动的调制。这种增加在正常受试者中更明显，而在帕金森病（PD）患者中较少，帕金森病是一种与新运动技能形成缺陷相关的疾病。在这里，我们调查了两种不同的治疗后，一组PD患者的EEG变化是否有所改善，以及这是否与表现有关。受试者在右后顶叶皮质接受5 Hz重复经颅磁刺激（rTMS）或4周多学科强化康复治疗（MIRT）。我们使用了一个达到任务与视觉运动适应旋转显示在增量10°的步骤高达60°。在连续两天的干预之前和之后，对所学旋转的保留进行了测试。在整个测试过程中记录高密度EEG。我们发现，患者适应他们的运动旋转显示类似的控制，虽然保留较差。rTMS和MIRT都能改善学习旋转的保持。平均β调节水平在MIRT后显著变化，而在rTMS后无显著变化。这些结果表明，rTMS产生的局部改善反映在增强的短期技能保留;另一方面，MIRT确定的变化，在对侧感觉运动区，反映在β脑电图的变化。
Movement is accompanied by modulation of oscillatory activity in different ranges over the sensorimotor areas. This increase is more evident in normal subjects and less in patients with Parkinson's Disease (PD), a disorder associated with deficits in the formation of new motor skills. Here, we investigated whether such EEG changes improved in a group of PD patients, after two different treatments and whether this relates to performance. Subjects underwent either a session of 5 Hz repetitive Transcranial Magnetic Stimulation (rTMS) over the right posterior parietal cortex or a 4-week Multidisciplinary Intensive Rehabilitation Treatment (MIRT). We used a reaching task with visuo-motor adaptation to a rotated display in incremental 10° steps up to 60°. Retention of the learned rotation was tested before and after either intervention over two consecutive days. High-density EEG was recorded throughout the testing. We found that patients adapted their movements to the rotated display similarly to controls, although retention was poorer. Both rTMS and MIRT lead to improvement in retention of the learned rotation. Mean beta modulation levels changed significantly after MIRT and not after rTMS. These results suggest that rTMS produced local improvement reflected in enhanced short-term skill retention; on the other hand, MIRT determined changes across the contralateral sensorimotor area, reflected in beta EEG changes.