Rehabilitation Response in Tremor- and Non-Tremor-Dominant Parkinson Disease: A Task-fMRI Study

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS

ACS Applied Bio Materials Pub Date : 2024-10-17 DOI:10.1002/brb3.70102

Keke Chen, Songjian Wang, Qiping Wen, Zhaohui Jin, Yixuan Wang, Detao Meng, Xin Yu, Mengyue Wang, Meng Lin, Youwei Li, Chunlin Li, Boyan Fang

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Abstract

Background

Tremor-dominant (TD) and nontremor-dominant (NTD) Parkinson's disease (PD) showed different responses to rehabilitation. However, the neural mechanism behind this remains unclear.

Methods

This cohort study explores changes in motor function, brain activation, and functional connectivity following 2 weeks of rehabilitation in TD-PD and NTD-PD patients, respectively. A total of 11 TD-PD patients, 24 NTD-PD patients, and 21 age-matched healthy controls (HCs) were included. At baseline, all participants underwent functional magnetic resonance imaging (fMRI) while performing the foot tapping task. Motor symptoms, gait, balance, and task-based fMRI were then evaluated in patients before and after rehabilitation.

Results

Compared to HCs, TD-PD patients showed increased activity in the left inferior frontal gyrus and the right insula, and NTD-PD patients showed increased activations in the left postcentral gyrus and decreased within-cerebellar connectivity at baseline. Rehabilitation improved motor function in PD patients regardless of motor subtype. TD-PD patients showed increased recruitments of the sensorimotor cortex and the bilateral thalamus after rehabilitation, and NTD-PD patients showed increased cerebellar activation and within-cerebellar connectivity that was associated with better motor performance.

Conclusions

This study demonstrated that rehabilitation-induced brain functional reorganization varied by motor subtypes in PD, which may have important implications for making individualized rehabilitation programs.

Trial Registration

ClinicalTrials.gov identifier: ChiCTR1900020771

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震颤型和非震颤型帕金森病患者的康复反应：任务-核磁共振成像研究

背景震颤主导型（TD）和非震颤主导型（NTD）帕金森病（PD）患者对康复治疗表现出不同的反应。然而，其背后的神经机制仍不清楚。方法本队列研究探讨了 TD-PD 和 NTD-PD 患者分别进行 2 周康复治疗后运动功能、大脑激活和功能连接的变化。研究共纳入了 11 名 TD-PD 患者、24 名 NTD-PD 患者和 21 名年龄匹配的健康对照组（HCs）。在基线期，所有参与者在进行足部敲击任务时都接受了功能磁共振成像（fMRI）检查。然后对患者康复前后的运动症状、步态、平衡和基于任务的 fMRI 进行评估。结果与正常人相比，TD-PD 患者左侧额叶下回和右侧岛叶的活动增加，NTD-PD 患者左侧中央后回的活动增加，小脑内的连接在基线时减少。无论运动亚型如何，康复治疗都能改善帕金森病患者的运动功能。TD-PD患者在康复后感觉运动皮层和双侧丘脑的募集增加，NTD-PD患者的小脑激活和小脑内连接增加，这与运动表现的改善有关。结论本研究表明，康复诱导的脑功能重组因运动亚型而异，这可能对制定个体化康复计划具有重要意义。试验注册 ClinicalTrials.gov identifier：ChiCTR1900020771

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来源期刊

ACS Applied Bio Materials Chemistry-Chemistry (all)

CiteScore

9.40

自引率

2.10%

发文量

464