OCULOMOTOR CONTROL AND GAIT IN PARKINSON DISEASE

摘要 许多患有帕金森病（PD）的个体经历活动性降低伴步态困难， 包括可能引发冻结的转向障碍。这些转向困难是特别关键，因为福尔斯 转弯时的髋部骨折风险比直线行走时的福尔斯高八倍。 此外，PD患者发生髋部骨折的可能性是年龄匹配的人的三倍多。 没有PD的人群，PD患者髋部骨折的护理费用约为1.92亿美元 每一年。考虑到与福尔斯相关的个人和经济影响， 干预措施，以减少PD患者在转身过程中跌倒的风险。 PD中转向受损的机制尚不清楚。我们认为：1）PD患者 有转向困难的人将表现出快速切换运动方向的能力受损， 而且眼睛和2）眼睛运动损伤可能导致转动困难。通过使用 运动学和视频眼动图分析，沿着旋转圆形跑步机和视动刺激， 我们将确定：1）有转向困难的PD患者是否表现出能力受损， 快速转换眼睛和下肢的运动方向，以及2）眼睛运动是否存在缺陷 控制有助于PD转向困难。拟议研究的长期目标是更好地 了解PD患者的眼部和肢体运动控制缺陷之间的关系，以及如何 这些缺陷与转向受损有关。利用获得的知识，我们的目标是开发创新的步态 PD患者的康复方法，最终目标是减少福尔斯和髋部骨折， 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.