OCULOMOTOR CONTROL AND GAIT IN PARKINSON DISEASE

摘要 许多帕金森病(PD)患者的行动能力下降，步态困难， 包括可能引发冰冻的转动障碍。自秋季以来，这些转弯困难尤为关键 转身时髋部骨折的风险是直线行走时跌倒时的八倍。 此外，帕金森病患者发生髋部骨折的可能性是同龄患者的三倍多。 没有PD的队列，PD患者的髋部骨折护理费用约为1.92亿美元 每年。考虑到与跌倒相关的个人和经济影响，我们发展 减少帕金森病患者转身过程中下降风险的干预措施。 帕金森病转折障碍的潜在机制尚不清楚。我们认为：1)帕金森病患者 转身有困难的人会表现出快速切换运动方向的能力受损，而不仅仅是四肢 但眼睛和眼球运动障碍也可能导致转身困难。通过使用 运动学和录像分析，以及旋转的圆形跑步机和视动刺激， 我们将确定：1)有转向困难的帕金森病患者是否表现出能力障碍 快速切换眼睛和肢体的运动方向；2)是否存在眼球运动障碍 控制导致帕金森病的转折性困难。拟议研究的长期目标是更好地 了解帕金森病患者眼球运动和肢体运动控制缺陷之间的关系以及如何 这些缺陷与转弯受损有关。利用所获得的知识，我们的目标是开发创新的步态 帕金森病患者的康复方法，最终目标是减少跌倒和髋部骨折 人口。

Abstract Many individuals with Parkinson disease (PD) experience a reduction in mobility with gait difficulties that include impaired turning that can trigger freezing. These turning difficulties are particularly critical since falls during turning carry an eightfold greater risk of hip fracture compared to falls during straight line walking. Furthermore, people with PD are over three times more likely to sustain a hip fracture than age-matched cohorts without PD, and the cost of care for hip fractures in individuals with PD is approximately $192 million per year. Given the personal and economic impacts associated with falls, it is critical that we develop interventions to reduce falling risk during turning among those with PD. Mechanisms underlying impaired turning in PD are not well understood. We think that: 1) individuals with PD who have difficulty turning will show impaired ability to rapidly switch movement directions of not just the limbs but also the eyes and 2) eye movement impairments may contribute to difficulties with turning. Through use of kinematic and videooculographic analyses, along with a rotating circular treadmill and optokinetic stimulation, we will determine: 1) whether individuals with PD who have turning difficulty show impairments in ability to rapidly switch movement direction of the eyes and lower limbs, and 2) whether deficits in eye movement control contribute to turning difficulties in PD. The long-term objective of the proposed research is to better understand the relationship between oculomotor and limb motor control deficits in individuals with PD and how these deficits relate to impaired turning. Using the knowledge gained, we aim to develop innovative gait rehabilitation approaches for individuals with PD with the ultimate goal of reducing falls and hip fractures in this population.