使用经颅磁刺激探测帕金森病跑步机训练后的神经可塑性和预测步态表现

IF 7.4 1区医学 Q1 CLINICAL NEUROLOGY

Movement Disorders Pub Date : 2024-12-31 DOI:10.1002/mds.30100

Si-Yu Tsai DPT, Chun-Hwei Tai MD, PhD, Ya-Yun Lee PT, PhD

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引用次数: 0

摘要

背景：步长减少是帕金森病患者步态障碍的标志。尽管跑步机训练对提高步长是有效的，但相关的神经机制尚未得到充分的研究。此外，探索训练后步长改善的基线神经生理学预测因子可以促进PD的个性化步态康复。目的研究跑步机训练后皮质运动兴奋性的神经可塑性变化，并探讨基线神经生理指标是否可以预测PD患者步长改善。方法61例特发性PD患者完成12次跑步机训练。在基线、干预后和1个月的随访中，通过经颅磁刺激（TMS）测量步态表现和皮质运动兴奋性。TMS结果包括运动诱发电位、皮质沉默期（CSP）、皮质内促进（ICF）和短间期皮质内抑制（SICI）。使用一般估计方程分析和主成分分析来确定训练引起的神经可塑性变化，并使用多元线性回归分析来探索1个月随访时步长改善的基线TMS预测因子。结果在跑步机训练后，SICI和CSP显著增加，并呈现出一种新的关系。回归分析显示，女性性别和较大的基线ICF和SICI是随访时步长改善的重要预测因素。结论本研究提高了对帕金森病跑步机训练引起的神经可塑性改变的认识，并表明保留的SICI和ICF是训练后持续步长改善的预测指标。未来的研究可以探讨跑步机训练对帕金森病的其他影响因素。©2024国际帕金森和运动障碍学会。

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Use of Transcranial Magnetic Stimulation to Probe Neuroplasticity and Predict Gait Performance After Treadmill Training in Parkinson's Disease

Background

Reduced step length is a hallmark of gait disturbance in people with Parkinson's disease (PD). Although treadmill training is effective for improving step length, the associated neural mechanisms have not been fully investigated. Moreover, exploring the baseline neurophysiological predictors for step length improvement after training could facilitate personalized gait rehabilitation for PD.

Objective

The aim of this study was to investigate the neuroplastic changes in corticomotor excitability after treadmill training and to explore whether baseline neurophysiological measures could predict step length improvement in PD.

Methods

Data from 61 participants with idiopathic PD who completed 12 treadmill training sessions were included. Gait performances and corticomotor excitability measured by transcranial magnetic stimulation (TMS) were obtained at baseline, postintervention, and 1-month follow-up. TMS outcomes included motor-evoked potentials, cortical silent period (CSP), intracortical facilitation (ICF), and short-interval intracortical inhibition (SICI). General estimating equation analysis and principal-component analyses were used to determine the neuroplastic changes induced by training, and multiple linear regression analysis was performed to explore the baseline TMS predictors for step length improvement at 1-month follow-up.

Results

After treadmill training, SICI and CSP significantly increased and shared an emerging relationship. Regression analysis showed that female sex and greater baseline ICF and SICI were significant predictors of step length improvement at the follow-up.

Conclusions

This study advanced the understanding of neuroplastic changes induced by treadmill training in PD and showed that preserved SICI and ICF were predictors for lasting step length improvement after training. Future studies could investigate other influential factors for treadmill training in PD. © 2024 International Parkinson and Movement Disorder Society.

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来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.