Brain plasticity in Parkinson’s disease with freezing of gait induced by action observation training

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• 作者：Federica Agosta ; Roberto Gatti ; Elisabetta Sarasso…
• 关键词：Parkinson’s disease ; Action observation ; Gait disorders ; Freezing of gait ; Functional MRI
• 刊名：Journal of Neurology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：264
• 期：1
• 页码：88-101
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Neurology; Neurosciences; Neuroradiology;
• 出版者：Springer Berlin Heidelberg
• ISSN：1432-1459
• 卷排序：264

文摘

Gait disorders represent a therapeutic challenge in Parkinson’s disease (PD). This study investigated the efficacy of 4-week action observation training (AOT) on disease severity, freezing of gait and motor abilities in PD, and evaluated treatment-related brain functional changes. 25 PD patients with freezing of gait were randomized into two groups: AOT (action observation combined with practicing the observed actions) and “Landscape” (same physical training combined with landscape-videos observation). At baseline and 4-week, patients underwent clinical evaluation and fMRI. Clinical assessment was repeated at 8-week. At 4-week, both groups showed reduced freezing of gait severity, improved walking speed and quality of life. Moreover, AOT was associated with reduced motor disability and improved balance. AOT group showed a sustained positive effect on motor disability, walking speed, balance and quality of life at 8-week, with a trend toward a persisting reduced freezing of gait severity. At 4-week vs. baseline, AOT group showed increased recruitment of fronto-parietal areas during fMRI tasks, while the Landscape group showed a reduced fMRI activity of the left postcentral and inferior parietal gyri and right rolandic operculum and supramarginal gyrus. In AOT group, functional brain changes were associated with clinical improvements at 4-week and predicted clinical evolution at 8-week. AOT has a more lasting effect in improving motor function, gait and quality of life in PD patients relative to physical therapy alone. AOT-related performance gains are associated with an increased recruitment of motor regions and fronto-parietal mirror neuron and attentional control areas.