Basal ganglia and beyond: The interplay between motor and cognitive aspects in Parkinson’s disease rehabilitation

Ferrazzoli, Davide; Ortelli, Paola; Madeo, Graziella; Giladi, Nir; Petzinger, Giselle M.; Frazzitta, Giuseppe

doi:10.1016/j.neubiorev.2018.05.007

Cited by 82 publications

(88 citation statements)

References 183 publications

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“…There is growing evidence that physiotherapy interventions improve gait [13][14][15][16][17][18][19] and balance performance in PD [20][21][22][23][24][25][26][27][28]. Physiotherapy typically involves functional gait and balance exercises [9,10,24] that translate directly to daily life activities [29][30][31]. Moreover, compensation strategies such as rhythmic auditory cueing [32] have an immediate effect on walking speed, stride length and cadence [16,17,33].…”

Section: Introductionmentioning

confidence: 99%

Multimodal Balance Training Supported by Rhythmical Auditory Stimuli in Parkinson’s Disease: A Randomized Clinical Trial

Capato

Vries²,

IntHout³

et al. 2019

Journal of Parkinson’s Disease

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Background: Balance impairment in Parkinson's disease (PD) improves only partially with dopaminergic medication. Therefore, non-pharmacological interventions such as physiotherapy are important elements in clinical management. External cues are often applied to improve gait, but their effects on balance control are unclear. Objective/Methods: We performed a prospective, single-blind, randomized clinical trial to study the effectiveness of balance training with and without rhythmical auditory cues. We screened 201 volunteers by telephone; 154 were assigned randomly into three groups: (1) multimodal balance training supported by rhythmical auditory stimuli (n = 56) (RAS-supported multimodal balance training); (2) regular multimodal balance training without rhythmical auditory stimuli (n = 50); and (3) control intervention involving a general education program (n = 48). Training was performed for 5 weeks, two times/week. Linear mixed models were used for all outcomes. Primary outcome was the Mini-BESTest (MBEST) score immediately after the training period. Assessments were performed by a single, blinded assessor at baseline, immediately post intervention, and after one and 6-months follow-up. Results: Immediately post intervention, RAS-supported multimodal balance training was more effective than regular multimodal balance training on MBEST (difference 3.5 (95% Confidence Interval (CI) 2.2; 4.8)), p < 0.001). Patients allocated to both active interventions improved compared to controls (MBEST estimated mean difference versus controls 6.6 (CI 5.2; 8.0), p < 0.001 for RAS-supported multimodal balance training; and 3.0 (CI 2.7; 5.3), p < 0.001 for regular multimodal balance training). Improvements were retained at one-month follow-up for both active interventions, but only the RAS-supported multimodal balance training group maintained its improvement at 6 months. Conclusion: Both RAS-supported multimodal balance training and regular multimodal balance training improve balance, but RAS-supported multimodal balance training-adding rhythmical auditory cues to regular multimodal balance traininghas greater and more sustained effects.

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Section: Introductionmentioning

confidence: 99%

Multimodal Balance Training Supported by Rhythmical Auditory Stimuli in Parkinson’s Disease: A Randomized Clinical Trial

Capato

Vries²,

IntHout³

et al. 2019

Journal of Parkinson’s Disease

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“…Participants demonstrated difficulties in conducting the task in a smooth manner ("flows"), persisting with actions in a coordinated manner, making motor adjustments ("calibrates", "coordinates", "adjusts") and altering performance speed to conform to task requirements ("times"). Reduced automatic internal responses to control, time and continue motor performance are well-known problems in PD and relate to dysfunction in the basal ganglia (5,25). To enhance movement, it is suggested that people with PD can use compensatory strategies that bypass the basal ganglia and tap into higher level attention strategies, sensory cueing and planning strategies (5,26,27).…”

Section: Discussionmentioning

confidence: 99%

“…People with PD have difficulty performing habitual daily tasks, requiring them to use higher level thinking strategies to carry out daily activities that were previously automatic (4,5). At the same time, people with PD may experience cognitive deficits in executive functions, attention, processing speed, working memory and visuospatial functions (6).…”

mentioning

confidence: 99%

Applied cognitive strategy behaviours in people with Parkinson´s disease during daily activities: A cross-sectional study

Sturkenboom

Nott²,

Bloem

et al. 2020

J Rehabil Med

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When performing daily activities, people use internally generated cognitive strategies, or ways of thinking, to plan and execute appropriate actions. This is known as applied cognition. This article describes a study that sought to measure the efficiency of applied cognition of 190 persons with non-dementing Parkinson's disease who were living at home. Participants were asked to perform a usual activity in their own homes. Their performance was videotaped and scored by assessors. The standardized observation instrument measured the effective use of 34 applied cognitive strategy behaviours. These behaviours represent 4 information-processing domains: attention and sensory processing (Perceive), accessing task-related knowledge (Recall), planning and evaluation (Plan), and performance control (Perform). The results indicated that applied cognitive strategies used to plan, evaluate and control performance were the least efficient. The most efficient were those used for sensory discrimination and recalling facts. The subgroup with the more advanced Parkinson's disease had the least efficient use of applied cognition. The results may inform further development of suitable interventions to optimize activity performance. Objective: To explore the use of applied cognitive strategy behaviours during performance of daily activities in people with Parkinson's disease. Design: Quantitative cross-sectional design. Methods: A total of 190 persons living at home with non-dementing Parkinson's disease were videotaped while performing a self-chosen activity in their natural environment. The videotaped performance was scored using the "Perceive, Recall, Plan & Perform System of Task Analysis" to measure: (i) performance mastery; and (ii) effective use of 34 cognitive strategy behaviours covering: attention and sensory processing (Perceive), accessing taskrelated knowledge (Recall), response planning and evaluation (Plan) and performance control (Perform). Mean performance mastery and a hierarchy of least to most effective applied cognitive strategy behaviours were determined for the total group and for 2 subgroups based on disease severity. A multifaceted Rasch model was used for data analysis. Results: Mean performance mastery was 56% (standard deviation 28%). Least efficient cognitive strategy behaviours were those used for planning, evaluating and controlling performance and most efficient strategies were those used for sensory discrimination and recalling factual information. More advanced disease indicated less efficient use of applied cognition. Conclusion: The results suggest that the efficiency of applied cognitive strategy behaviours is compromised in a certain pattern in people with Parkinson's disease, and that it declines with disease progression.

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“…It is clear that the system participates in numerous non-motor functions that include motivational and emotional processing that involves integrating internal and external information (Berridge & Cromwell, 1990;Ferrazzoli et al, 2018;Salamone, Yohn, Lopez-Cruz, San Miguel, & Correa, 2016;Schneider & Lidsky, 1981). The pallidal region has medial (i.e., internal segment), lateral (i.e., external segment), and ventral subregions; and the substantia nigra contains two main subregions: the pars compacta and the pars reticulata.…”

Section: Ba Sal G Ang Lia Sys Tem: Fun C Ti On and Dys Fun C Tionmentioning

confidence: 99%

“…This set of BG structures comprises the largest subcortical system in the brain, and its complex connectivity and internal structure have made it extremely difficult to address questions about its functional nature. It is clear that the system participates in numerous non-motor functions that include motivational and emotional processing that involves integrating internal and external information (Berridge & Cromwell, 1990;Ferrazzoli et al, 2018;Salamone, Yohn, Lopez-Cruz, San Miguel, & Correa, 2016;Schneider & Lidsky, 1981).…”

Section: Ba Sal G Ang Lia Sys Tem: Fun C Ti On and Dys Fun C Tionmentioning

confidence: 99%

Translating striatal activity from brain slice to whole animal neurophysiology: A guide for neuroscience research integrating diverse levels of analysis

Cromwell

2019

J of Neuroscience Research

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An important goal of this review is highlighting research in neuroscience as examples of multilevel functional and anatomical analyses addressing basic science issues and applying results to the understanding of diverse disorders. The research of Dr. Michael Levine, a leader in neuroscience, exemplifies this approach by uncovering fundamental properties of basal ganglia function and translating these findings to clinical applications. The review focuses on neurophysiological research connecting results from in vitro and in vivo recordings. A second goal is to utilize these research connections to produce novel, accurate descriptions for corticostriatal processing involved in varied, complex functions. Medium spiny neurons in striatum act as integrators combining input with baseline activity creating motivational “events.” Basic research on corticostriatal synapses is described and links developed to issues with clinical relevance such as inhibitory gating, self‐injurious behavior, and relative reward valuation. Work is highlighted on dopamine–glutamate interactions. Individual medium spiny neurons express both D1 and D2 receptors and encode information in a bivalent manner depending upon the mix of receptors involved. Current work on neurophysiology of reward processing has taken advantage of these basic approaches at the cellular and molecular levels. Future directions in studying physiology of reward processing and action sequencing could profit by incorporating the divergent ways dopamine modulates incoming neurochemical signals. Primary investigators leading research teams should mirror Mike Levine's efforts in “climbing the mountain” of scientific inquiry by performing analyses at different levels of inquiry, integrating the findings, and building comprehensive answers to problems unsolvable without this bold approach.

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Basal ganglia and beyond: The interplay between motor and cognitive aspects in Parkinson’s disease rehabilitation

Cited by 82 publications

References 183 publications

Multimodal Balance Training Supported by Rhythmical Auditory Stimuli in Parkinson’s Disease: A Randomized Clinical Trial

Multimodal Balance Training Supported by Rhythmical Auditory Stimuli in Parkinson’s Disease: A Randomized Clinical Trial

Applied cognitive strategy behaviours in people with Parkinson´s disease during daily activities: A cross-sectional study

Translating striatal activity from brain slice to whole animal neurophysiology: A guide for neuroscience research integrating diverse levels of analysis

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