Exploring the Limits of Human Motor Control in Healthy Subjects and Patients with Parkinson's Disease

Exploring the Limits of Human Motor Control in Healthy Subjects and Patients with Parkinson's Disease
Author: Wei-Peng Teo
Publisher:
Total Pages:
Release: 2013
Genre:
ISBN:

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[Truncated abstract] Previously, it was postulated that the phenomenon of post-exercise corticomotor depression reflected fatigue of the central nervous system following demanding exercises. However, peripheral fatigue is implicated with maximally demanding exercises, which makes it difficult to ascertain the mechanisms underlying post-exercise corticomotor depression. Recently, Rodrigues et al. (2009) reported a novel index finger flexion-extension task performed at maximal voluntary rate that breaks down rapidly in the absence of peripheral fatigue. They suggested that a loss in central motor command was the most likely cause due to the lack of peripheral changes. To determine the extent in which central change are involved in the breakdown of movement following the index finger flexion-extension task, the aims were to, firstly, investigate the dynamics of post-exercise corticomotor depression and short-interval intra-cortical inhibition following a 10-sec flexion-extension task at maximal and submaximal voluntary rates in both the dominant and non-dominant hand. Secondly, determine if motor practice and neuro-modulation will attenuate movement breakdown during the maximal voluntary rate task. Finally, the thesis will compare the relevance of the flexion-extension task against the finger-tapping task) in Parkinson's disease patients, and to determine the dynamics of post-exercise corticomotor depression following the flexion-extension task in Parkinson's disease patients during OFF and ON levodopa medication. The kinematic findings showed that healthy subjects were not able to sustain both movement rate and movement amplitude throughout a 10-sec index finger flexionextension task at maximal voluntary rate. No change in pre- and post-task ballistic finger flexion/extension speed and M-wave amplitude was observed. A period of post-exercise corticomotor depression and increased short-interval cortical inhibition lasting up to 6 minutes was also observed. Paradoxically, the results also showed that postexercise corticomotor depression and short-interval cortical inhibition were more profound following the flexion-extension task performed at a moderate sustainable rate. Between-hand comparisons also showed an increase in post-exercise corticomotor depression and short-interval cortical inhibition following tasks performed by the dominant hand. The effects of motor practice and neuro-modulation (using a repetitive TMS paradigm at I-wave frequency [ITMS]) on motor performance and learning of the flexion-extension task at maximal voluntary rate were then investigated. Subjects were randomised into a 15-min sham- or real-ITMS that was delivered prior to 6 practice sets of 10-sec flexion-extension task at maximal voluntary rate. Immediately after sham- ITMS, no change in corticomotor excitability was observed compared to baseline. However, motor practice lead to improved task sustainability as demonstrated by a reduction in the decline in movement rate. Corticomotor excitability increased steadily after each training bout, and was maintained up to 20 min after the last practice bout. Following real-ITMS, an increase in corticomotor excitability was immediately observed...

A Study of Motor Control in Healthy Subjects and in Parkinson's Disease Patients

A Study of Motor Control in Healthy Subjects and in Parkinson's Disease Patients
Author: Shelly Levy-Tzedek
Publisher:
Total Pages: 215
Release: 2008
Genre:
ISBN:

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(cont.) Bradykinesia (slowness of movement) is one of the hallmarks of PD. We examined the effects of visual feedback on bradykinesia. PD patients off dopaminergic medication and healthy age-matched controls performed significantly faster movements when visual feedback was withdrawn. For the bradykinetic subjects, this increase in movement speed meant either a mitigation or an elimination of bradykinesia. Our results support a role of the basal ganglia in sensorimotor integration, and argue for the integration of nonvision exercises into patients' physical therapy regime.

Balance Dysfunction in Parkinson’s Disease

Balance Dysfunction in Parkinson’s Disease
Author: Martina Mancini
Publisher: Academic Press
Total Pages: 226
Release: 2019-09-14
Genre: Medical
ISBN: 0128138750

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Balance Dysfunction in Parkinson’s Disease: Basic Mechanisms to Clinical Management presents the most updated information on a variety of topics. Sections help clinicians evaluate the types of balance control issues, dynamic balance dysfunction during turning, and the effects of medication, deep brain stimulation, and rehabilitation intervention on balance control. This book is the first to review the four main postural control systems and how they are affected, including balance during quiet stance, reactive postural adjustments to external perturbations, anticipatory postural adjustments in preparation for voluntary movements, and dynamic balance control during walking and turning. In addition, the book's authors summarize the effects of levodopa, deep brain stimulation, and rehabilitation intervention for each balance domain. This book is recommended for anyone interested in how and why balance control is affected by PD. Provides the first comprehensive review of research to date on balance dysfunctions in Parkinson's disease Discusses how to translate current neuroscience research into practice regarding neural control of balance Provides evidence on the effects of current interventions on balance control

Neurophysiological Mechanisms of Motor Control Deficits in Parkinson's Disease

Neurophysiological Mechanisms of Motor Control Deficits in Parkinson's Disease
Author: Elizabeth Heinrichs-Graham
Publisher:
Total Pages: 64
Release: 2015
Genre: Brain
ISBN: 9781321812473

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Parkinson’s disease (PD) is the second most common neurodegenerative disorder in the world. It is associated with progressive motor, postural, and gait abnormalities, and presently has no known cause or cure. While the behavioral symptomatology has been well-characterized, the neurophysiological underpinnings of these symptoms are only vaguely understood. Previous invasive studies using local field potentials and scalp electroencephalography have shown pathological beta synchronization during rest throughout the cortical-basal ganglia motor network in patients with severe PD. In healthy humans, there is a specific pattern of beta desynchronization and resynchronization in the motor cortices that is necessary for the proper execution of movement. Thus, it is possible that the pathological beta synchronization observed in patients with PD may directly or indirectly perturb the healthy pattern of cortical desynchronization/resynchronization, and in turn generate motor-related symptoms. For my Master’s thesis, we used magnetoencephalography (MEG) to investigate whether these oscillatory beta responses were abnormal during hand movements in patients with PD relative to matched controls. MEG is a noninvasive neurophysiological imaging technique with exceptional temporal resolution and good spatial accuracy, which permits recording of population-level oscillatory activity during movement planning, execution, and termination. My thesis showed that patients with PD have significantly diminished beta desynchronization compared with controls prior to and during movement, which likely indicates abnormalities in motor planning and movement selection. Patients also exhibited marginally significant reductions in the post-movement beta rebound, indicative of motor plan termination deficits. In my Ph.D. Dissertation project, we followed-up these findings by using MEG and three novel motor sequence planning/termination tasks to evaluate the nature of these deficits in un-medicated patients with PD and a matched group of healthy adults. In the first task, the Motor Time experiment, participants executed finger-tapping sequences, while we manipulated the amount of available time they had to plan the movement prior to motor execution. We found that patients with PD performed comparatively to controls, despite having reduced beta ERD amplitude throughout the motor cortical network. In the second task, the Motor Complexity task, the complexity of the to-be-executed motor plan was manipulated. In this experiment, patients with PD exhibited significantly different patterns of beta activity compared to healthy controls while performing Simple relative to Complex sequences, and also performed significantly worse than healthy controls across conditions. In the third task, the Motor Termination task, we manipulated when participants were forced to terminate a specific motor command. Patients with PD terminated movement at a significantly slower velocity than healthy controls, despite exhibiting largely comparable post-movement beta activity. Taken together, these data suggest that beta aberrations in PD are specific to distinct components and parameters of the motor control process, and may help direct future development of new treatment avenues and physiological biomarkers of disease progression and treatment efficacy.

An Essay on the Shaking Palsy

An Essay on the Shaking Palsy
Author: James Parkinson
Publisher:
Total Pages: 86
Release: 1817
Genre: Parkinson's disease
ISBN:

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Non-Motor Symptoms of Parkinson's Disease

Non-Motor Symptoms of Parkinson's Disease
Author: K. Ray Chaudhuri
Publisher: Oxford University Press, USA
Total Pages: 517
Release: 2014
Genre: Medical
ISBN: 0199684243

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Patients with Parkinson's disease (PD) are known to suffer from motor symptoms of the disease, but they also experience non-motor symptoms (NMS) that are often present before diagnosis or that inevitably emerge with disease progression. The motor symptoms of Parkinson's disease have been extensively researched, and effective clinical tools for their assessment and treatment have been developed and are readily available. In contrast, researchers have only recently begun to focus on the NMS of Parkinson's Disease, which are poorly recognized and inadequately treated by clinicians. The NMS of PD have a significant impact on patient quality of life and mortality and include neuropsychiatric, sleep-related, autonomic, gastrointestinal, and sensory symptoms. While some NMS can be improved with currently available treatments, others may be more refractory and will require research into novel (non-dopaminergic) drug therapies for the future. Edited by members of the UK Parkinson's Disease Non-Motor Group (PD-NMG) and with contributions from international experts, this new edition summarizes the current understanding of NMS symptoms in Parkinson's disease and points the way towards future research.