Does visuospatial motion perception correlate with coexisting movement disorders in Parkinson's disease?
Does visuospatial motion perception correlate with coexisting movement disorders in Parkinson's disease?
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视觉空间运动知觉与帕金森病患者共存的运动障碍相关吗？
DOI：
10.1007/s00415-021-10804-2
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发表时间：
2022-04
影响因子：
6
通讯作者：
Shaikh AG
中科院分区：
文献类型：
--
作者：
Beylergil SB;Gupta P;ElKasaby M;Kilbane C;Shaikh AG
姿势不稳定和平衡障碍在帕金森病 (PD) 中很常见。多种因素，例如张力增加、运动迟缓、步态冻结、姿势、轴向僵硬和四肢不自主运动，都会影响平衡。最近的研究发现PD患者前庭区存在自我运动感知异常。我们询问平衡功能的测量（例如对运动的感知）是否与 PD 中出现的特定运动障碍相关。移动的视网膜图像或空间中的自我运动会触发自我运动的感知。当使用移动平台（前庭航向）整体移动受试者时，我们测量了一个人的线性运动（航向）感知。通过让受试者使用沉浸式虚拟现实护目镜观看 3D 光流，在视觉领域（视觉航向）产生类似的运动感知。在这两项任务中，受试者都以两种选择的强制选择范式报告了运动方向。感知运动方向的准确性是根据心理测量函数曲线拟合的响应来计算的，以估计受试者感知向右与向左运动的准确度和精确度（即阈值和斜率）。反应准确性和心理测量参数与疾病持续时间、疾病严重程度（总统一帕金森病评定量表-III，UPDRS-III）以及UPRDS-III的震颤、强直、轴向、步态/姿势成分相关。我们还使用特定活动平衡成分（ABC）量表将航向感知与跌倒次数以及平衡信心的主观评估相关联。前庭方向知觉的准确性、阈值和敏感性与疾病持续时间和严重程度（尤其是震颤）显着相关。前庭区域的向左方向感知的相关性更强。视觉航向感知与ABC量表相关，尤其是与光流处理相关的项目。左前庭方向与右前庭方向知觉不对称。不对称程度与 UPDRS-III 的轴向分量相关。与视觉和前庭方向知觉相关的临床参数的差异表明，两个方向知觉过程具有不同的机械基础。前庭和视觉方向知觉与疾病严重程度和持续时间之间的不一致表明视觉功能可用于 PD 患者的平衡康复。
Postural instability and balance impairment are common in Parkinson’s disease (PD). Multiple factors, such as increased tone, bradykinesia, freezing of gait, posture, axial stiffness, and involuntary appendicular movements, can affect balance. The recent studies found that PD patients have abnormal perception of self-motion in vestibular domain. We asked whether measures of balance function, such as perception of one’s motion, correlate with specific movement disorders seen in PD. Moving retinal image or self-motion in space triggers the perception of self-motion. We measured one’s linear motion (heading) perception when subjects were moved en bloc using a moving platform (vestibular heading). Similar motion perception was generated in the visual domain (visual heading) by having the subjects view a 3D optical flow with immersive virtual reality goggles. During both tasks, the subjects reported the motion direction in the two-alternative-forced-choice paradigm. The accuracy of perceived motion direction was calculated from the responses fitted to the psychometric function curves to estimate how accurately and precisely the subjects can perceive rightward versus leftward motion (i.e., threshold and slope). Response accuracies and psychometric parameters were correlated with the disease duration, disease severity (total Unified Parkinson’s Disease Rating Scale-III, UPDRS-III), and tremor, rigidity, axial, gait/posture components of UPRDS-III. We also correlated heading perception with the number of falls and subjective assessment of balance confidence using the Activities-Specific Balance Component (ABC) Scale. Accuracy, threshold, and sensitivity of vestibular heading perception significantly correlated with the disease duration and severity, particularly the tremor. Correlations were stronger for leftward heading perception in the vestibular domain. The visual heading perception was correlated with ABC Scale, especially with its items concerning optic-flow processing. There was asymmetry in leftward versus rightward vestibular heading perception. The level of asymmetry correlated with the axial component of UPDRS-III. Differences in the clinical parameters that correlate with visual versus vestibular heading perception suggest that two heading perception processes have different mechanistic underpinnings. The correlation of discordance between vestibular and visual heading perception with disease severity and duration suggests that visual function can be utilized for balance rehab in PD patients.
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