Brain Dynamics Underlying Preserved Cycling Ability in Patients With Parkinson’s Disease and Freezing of Gait

Abstract

Parkinson’s disease (PD) is generally associated with abnormally increased beta band oscillations in the cortico-basal ganglia loop during walking. PD patients with freezing of gait (FOG) exhibit a more distinct, prolonged narrow band of beta oscillations that are locked to the initiation of movement at ∼18 Hz. Upon initiation of cycling movements, this oscillation has been reported to be weaker and rather brief in duration. Due to the suppression of the overall beta band power during cycling and its continuous nature of the movement, cycling is considered to be less demanding for cortical networks compared to walking, including reduced need for sensorimotor processing, and thus unimpaired continuous cycling motion. Furthermore, cycling has been considered one of the most efficient non-pharmacological therapies with an influence on the subthalamic nucleus (STN) beta rhythms implicative of the deep brain stimulation effects. In the current review, we provide an overview of the currently available studies and discuss the underlying mechanism of preserved cycling ability in relation to the FOG in PD patients. The mechanisms are presented in detail using a graphical scheme comparing cortical oscillations during walking and cycling in PD.

Enhancing balance in Parkinson's disease patients

“…To reduce variability in results, future studies should research tailored interventions for different diseases stages. It is well known that Parkinson's disease patients often have a preserved ability to cycle (Licen, Rakusa, Bohnen, Manganotti, & Marusic, 2022). This represents a unique aspect of their motor function that must be considered when designing research studies.…”

Active and Passive Cycling Decrease Subthalamic β Oscillations in Parkinson's Disease

“…We recorded from 12 PD patients (age = 65.2 ± 6.1 years, five females, six with FOG, Table 1, contact zero indicates the most ventral contact) who were bilaterally implanted with DBS electrodes (model 3389, Medtronic Neurological Division, Minneapolis, MN) in the STN, connected to a Medtronic Percept PC neurostimulator. The diagnosis of PD was based on standard clinical criteria 18 . FOG and motor state were assessed preoperatively with the UPDRS III.…”

“…The diagnosis of PD was based on standard clinical criteria. 18 FOG and motor state were assessed preoperatively with the UPDRS III. At the time of the experiment, the patients completed the New Freezing of Gait Questionnaire (NFOG-Q), 22 which was used to classify the patients as freezers or non-freezers.…”

“…Many studies have contributed to the growing body of literature on the potential benefits of cycling as a therapeutic intervention for PD. [17][18][19] In this study, we investigated STN β (13-30 Hz) and high γ (60-100 Hz) power during both active and passive cycling with different cadences, and compared patients with and without FOG. The passive cycling experiment, where a motor provided a fixed cadence, allowed us to study the effect of isolated sensory information without motor activity.…”

“…Many studies have contributed to the growing body of literature on the potential benefits of cycling as a therapeutic intervention for PD 17‐19 . In this study, we investigated STN β (13–30 Hz) and high γ (60–100 Hz) power during both active and passive cycling with different cadences, and compared patients with and without FOG.…”