Efficacy of high-frequency rTMS in the treatment of gait disorder and cognition in patients with Parkinson's disease based on wearable devices and eye-movement assessments.

Autor:	Tang HY; Department of Neurology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China.; The Third People's Hospital of Baiyun District, Guangzhou, Guangdong, China., Liao X; Department of Neurology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China.; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China., Li P; Department of Anesthesiology and Surgery, Liwan Central Hospital of Guangzhou, Guangzhou, China., Zhang P; Guangdong Key Laboratory of Nanomedicine, CAS-HK Joint Lab of Biomaterials, CAS Key Laboratory of Biomedical Imaging Science and System, Chinese Academy of Sciences, Shenzhen, China., Yao J; Department of Neurology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China.; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China., Xing Y; Department of Neurology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China., Zhao X; Department of Neurology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China., He X; Department of Neurology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China., Zan J; School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou, Guangdong, China., Li G; Department of Neurology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China.; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.
Jazyk:	angličtina
Zdroj:	Frontiers in aging neuroscience [Front Aging Neurosci] 2024 Oct 16; Vol. 16, pp. 1480171. Date of Electronic Publication: 2024 Oct 16 (Print Publication: 2024).
DOI:	10.3389/fnagi.2024.1480171
Abstrakt:	Background: Postural instability and gait disorder and cognitive dysfunction are common symptoms of Parkinson's disease (PD). Scale assessment is frequently used in the clinic to evaluate PD, but this technique is limited by its lack of sensitivity to changes in disease progression and its difficulty in capturing subtle movements and changes in cognitive function. It is currently believed that high-frequency repetitive transcranial magnetic stimulation (rTMS) can improve motor and cognitive dysfunction in patients with PD, though it remains controversial. Therefore, it is imperative to monitor and dynamically identify changes in postural instability and gait disorder, as well as those in cognitive dysfunction, in PD to develop targeted interventions. In this study, we observed the effect of high-frequency rTMS on gait disorders and cognitive functions in patients with PD by comparing data from wearable devices and eye-tracking devices before and after treatment. Methods: A total of 159 patients with PD were included in this study. A GYENNO MATRIX wearable gait analyzer was used to monitor the objective gait data (including the timed up-and-go, narrow-track, and turning tests), the Eyeknow eye-tracking evaluation system was used to monitor the patient's eye movement cognition data (including the smooth pursuit, pro-saccade, and anti-saccade tests), and gait and cognitive function-related scales, including the Tinetti Balance Scale, Tinetti Gait Scale, Berg Balance Scale, Mini-Mental State Examination, and Montreal Cognitive Assessment (MoCA), were evaluated at the same time before and after high-frequency rTMS treatment. Results: The mean step length, mean stride velocity, stride length, and mean step frequency of patients with PD in the timed up-and-go test all increased compared with those before rTMS treatment, whereas the mean stride time and double support decreased. In the narrow-track test, the mean stride velocity increased and the mean stride time decreased. In the turning test, the turning left duration, turning right duration, mean duration, mean number of steps, and average step duration decreased, while the mean angular velocity increased after rTMS treatment. Compared with those before rTMS treatment, the latency period of patients with PD in overlapping saccades decreased, the completion time of overlapping saccades decreased, and the average saccade speed increased. In the anti-saccade test, the completion time decreased and the average saccade speed increased after rTMS treatment. Compared with those before rTMS treatment, the Tinetti Balance Scale, Tinetti Gait Scale, Berg Balance Scale, Mini-Mental State Examination, and MoCA scores increased, and the MoCA sub-items improved in terms of visual-spatial and executive function, language, abstraction, delayed recall, and orientation after rTMS treatment. Conclusion: High-frequency rTMS may be an effective therapy for improving gait disorders and cognitive functions in patients with PD. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Tang, Liao, Li, Zhang, Yao, Xing, Zhao, He, Zan and Li.)
Databáze:	MEDLINE
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