Gait improvement via rhythmic stimulation in Parkinson's disease is linked to rhythmic skills.
Gait improvement via rhythmic stimulation in Parkinson's disease is linked to rhythmic skills.
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DOI：
10.1038/srep42005
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发表时间：
2017-02-24
影响因子：
4.6
通讯作者：
Kotz SA
中科院分区：
文献类型：
--
作者：
Bella SD;Benoit CE;Farrugia N;Keller PE;Obrig H;Mainka S;Kotz SA
基于节律性听觉刺激（RAS）的训练可以改善特发性帕金森病（IPD）患者的步态。RAS后患者通常行走更快，步幅更大。然而，这种效果在患者中差异很大，有些患者对干预措施几乎没有反应。这些个体差异可能取决于患者将其运动与节拍同步的能力。为了测试这种可能性，14名IPD患者接受了为期四周的RAS治疗，在此期间，他们带着嵌入式节拍器跟随音乐行走。训练前后，患者的同步性进行了评估听觉节奏的手敲击和步行听觉线索。训练后，患者在非提示步态中的步态速度和步长增加。然而，个体差异是明显的，因为一些患者显示对RAS的阳性应答，而其他患者显示无应答或阴性应答。一个积极的反应RAS预测的同步性能在手轻敲和步态任务。更严重的步态障碍、低同步变异性和对刺激变化的迅速反应促进了对RAS训练的积极反应。因此，感觉运动计时技能支持的同步步骤的听觉线索，可以预测成功的RAS在IPD。
Training based on rhythmic auditory stimulation (RAS) can improve gait in patients with idiopathic Parkinson’s disease (IPD). Patients typically walk faster and exhibit greater stride length after RAS. However, this effect is highly variable among patients, with some exhibiting little or no response to the intervention. These individual differences may depend on patients’ ability to synchronize their movements to a beat. To test this possibility, 14 IPD patients were submitted to RAS for four weeks, in which they walked to music with an embedded metronome. Before and after the training, patients’ synchronization was assessed with auditory paced hand tapping and walking to auditory cues. Patients increased gait speed and stride length in non-cued gait after training. However, individual differences were apparent as some patients showed a positive response to RAS and others, either no response, or a negative response. A positive response to RAS was predicted by the synchronization performance in hand tapping and gait tasks. More severe gait impairment, low synchronization variability, and a prompt response to a stimulation change foster a positive response to RAS training. Thus, sensorimotor timing skills underpinning the synchronization of steps to an auditory cue may allow predicting the success of RAS in IPD.