Stopwatch training improves cognitive functions in patients with Parkinson's disease

Honma, Motoyasu; Murakami, Hidetomo; Yabe, Yoshiko; Kuroda, Takeshi; Futamura, Akinori; Sugimoto, Azusa; Terao, Yasuo; Masaoka, Yuri; Izumizaki, Masahiko; Kawamura, Mitsuru; Ono, Kenjiro

doi:10.1002/jnr.24812

Cited by 7 publications

(12 citation statements)

References 51 publications

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“…Thus, the "subjective" time scale is robust within each subject, returning to its "inherent" value after feedback training in PD patients in a relatively short while. A similar "return" is noted even in normal subjects, but occurring much more gradually over several hours (Honma et al, 2021). The "inherent" time scale may be partly determined by the pathophysiology underlying PD, cognitively or unconsciously by prior experience, or imposed by instantaneous and incoming prior sensory traces.…”

Section: Resultsmentioning

confidence: 57%

“…These distortions in time scale may occur through the very process of time production/reproduction (motor timing tasks), may be imposed by incoming prior sensory traces (perceptual timing tasks), get mixed in memory (reproduction tasks), and/or finally determined by the pathophysiology of PD. In this context, Honma et al (2018Honma et al ( , 2021 required PD patients to produce a subjective time interval of 10 s, and found that they tend to underproduce it, say, by about 2 s, i.e., they produced a time interval of 8 s on average, whereas normal subjects produced it closer to the veridical 10 s. PD patients were then given false feedback training in which they were trained with the veridical 10 s with feedback, by which the underproduction was temporarily corrected to be closer to the correct value (Honma et al, 2018(Honma et al, , 2021. However, their subjective sense of time returned to their pre-training performances within a few minutes after the feedback was removed.…”

Section: Resultsmentioning

confidence: 99%

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Time Distortion in Parkinsonism

et al. 2021

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Although animal studies and studies on Parkinson’s disease (PD) suggest that dopamine deficiency slows the pace of the internal clock, which is corrected by dopaminergic medication, timing deficits in parkinsonism remain to be characterized with diverse findings. Here we studied patients with PD and progressive supranuclear palsy (PSP), 3–4 h after drug intake, and normal age-matched subjects. We contrasted perceptual (temporal bisection, duration comparison) and motor timing tasks (time production/reproduction) in supra- and sub-second time domains, and automatic versus cognitive/short-term memory–related tasks. Subjects were allowed to count during supra-second production and reproduction tasks. In the time production task, linearly correlating the produced time with the instructed time showed that the “subjective sense” of 1 s is slightly longer in PD and shorter in PSP than in normals. This was superposed on a prominent trend of underestimation of longer (supra-second) durations, common to all groups, suggesting that the pace of the internal clock changed from fast to slow as time went by. In the time reproduction task, PD and, more prominently, PSP patients over-reproduced shorter durations and under-reproduced longer durations at extremes of the time range studied, with intermediate durations reproduced veridically, with a shallower slope of linear correlation between the presented and produced time. In the duration comparison task, PD patients overestimated the second presented duration relative to the first with shorter but not longer standard durations. In the bisection task, PD and PSP patients estimated the bisection point (BP50) between the two supra-second but not sub-second standards to be longer than normal subjects. Thus, perceptual timing tasks showed changes in opposite directions to motor timing tasks: underestimating shorter durations and overestimating longer durations. In PD, correlation of the mini-mental state examination score with supra-second BP50 and the slope of linear correlation in the reproduction task suggested involvement of short-term memory in these tasks. Dopamine deficiency didn’t correlate significantly with timing performances, suggesting that the slowed clock hypothesis cannot explain the entire results. Timing performance in PD may be determined by complex interactions among time scales on the motor and sensory sides, and by their distortion in memory.

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Section: Resultsmentioning

confidence: 57%

Section: Resultsmentioning

confidence: 99%

Time Distortion in Parkinsonism

et al. 2021

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“…G*Power (Version 3.1.9) specified that a sample size of 27 would be needed to obtain 70% power to detect a medium effect with an alpha of 0.05. Effect size (0.50) was determined by previous researches using temporal task (Honma et al, 2016(Honma et al, , 2017(Honma et al, , 2018(Honma et al, , 2021(Honma et al, , 2022Terao et al, 2021).…”

Section: Participantsmentioning

confidence: 99%

“…Subjective sense of time (temporal sense) is essential for perceiving and estimating the passage of time in daily life. Although the temporal sense is influenced by many factors, including circadian rhythms, emotion, and disease (Hancock et al, 1992;Honma et al, 2016;Mella et al, 2019), we previously showed that temporal sense is robust in each individual and consolidated at a stable value under certain conditions (Honma et al, 2021). This also holds for patients with Parkinson's disease (PD) in whom this is also robust and resistant to change; in the presence of dopamine deficiency, accurate time duration learned by feedback training quickly returns to inherent underestimated levels, and even after applying repetitive transcranial magnetic stimulation over the prefrontal cortex for inducing cortical plasticity and manipulating/consolidating time sense (Honma et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Role of the subthalamic nucleus in perceiving and estimating the passage of time

Honma

Sasaki²,

Kamo³

et al. 2023

Front. Aging Neurosci.

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Sense of time (temporal sense) is believed to be processed by various brain regions in a complex manner, among which the basal ganglia, including the striatum and subthalamic nucleus (STN), play central roles. However, the precise mechanism for processing sense of time has not been clarified. To examine the role of the STN in temporal processing of the sense of time by directly manipulating STN function by switching a deep brain stimulation (DBS) device On/Off in 28 patients with Parkinson’s disease undergoing STN-DBS therapy. The test session was performed approximately 20 min after switching the DBS device from On to Off or from Off to On. Temporal sense processing was assessed in three different tasks (time reproduction, time production, and bisection). In the three temporal cognitive tasks, switching STN-DBS to Off caused shorter durations to be produced compared with the switching to the On condition in the time production task. In contrast, no effect of STN-DBS was observed in the time bisection or time reproduction tasks. These findings suggest that the STN is involved in the representation process of time duration and that the role of the STN in the sense of time may be limited to the exteriorization of memories formed by experience.

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“…Alternatively, Wojtecki et al ( 44 ) observed improvements in time production and reproduction associated with high-, but not low-frequency STN of DBS. Honma et al ( 75 ) argue that stopwatch training even in medicated PD patients can improve time production tasks as well as performance in go-no-go tasks (associated with decreased impulsivity).…”

Section: Clinical Literature Reviewmentioning

confidence: 99%

Review: Subjective Time Perception, Dopamine Signaling, and Parkinsonian Slowness

Miyawaki

2022

Front. Neurol.

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The association between idiopathic Parkinson's disease, a paradigmatic dopamine-deficiency syndrome, and problems in the estimation of time has been studied experimentally for decades. I review that literature, which raises a question about whether and if dopamine deficiency relates not only to the motor slowness that is an objective and cardinal parkinsonian sign, but also to a compromised neural substrate for time perception. Why does a clinically (motorically) significant deficiency in dopamine play a role in the subjective perception of time's passage? After a discussion of a classical conception of basal ganglionic control of movement under the influence of dopamine, I describe recent work in healthy mice using optogenetics; the methodology visualizes dopaminergic neuronal firing in very short time intervals, then allows for correlation with motor behaviors in trained tasks. Moment-to-moment neuronal activity is both highly dynamic and variable, as assessed by photometry of genetically defined dopaminergic neurons. I use those animal data as context to review a large experimental experience in humans, spanning decades, that has examined subjective time perception mainly in Parkinson's disease, but also in other movement disorders. Although the human data are mixed in their findings, I argue that loss of dynamic variability in dopaminergic neuronal activity over very short intervals may be a fundamental sensory aspect in the pathophysiology of parkinsonism. An important implication is that therapeutic response in Parkinson's disease needs to be understood in terms of short-term alterations in dynamic neuronal firing, as has already been examined in novel ways—for example, in the study of real-time changes in neuronal network oscillations across very short time intervals. A finer analysis of a treatment's network effects might aid in any effort to augment clinical response to either medications or functional neurosurgical interventions in Parkinson's disease.

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Stopwatch training improves cognitive functions in patients with Parkinson's disease

Cited by 7 publications

References 51 publications

Time Distortion in Parkinsonism

Time Distortion in Parkinsonism

Role of the subthalamic nucleus in perceiving and estimating the passage of time

Review: Subjective Time Perception, Dopamine Signaling, and Parkinsonian Slowness

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