Paired inhibitory stimulation and gait training modulates supplemental motor area connectivity in freezing of gait
| Autor: | Steven A. Kautz, Daniel H. Lench, Alyssa N. Chesnutt, W. DeVries, Colleen A. Hanlon, Eric D. Monsch, Tonisha E. Kearney-Ramos, Jade D. Doolittle, Gonzalo J. Revuelta, Aaron E. Embry |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Male Cerebellum medicine.medical_specialty Parkinson's disease medicine.medical_treatment Article 03 medical and health sciences 0302 clinical medicine Gait (human) Physical medicine and rehabilitation Gait training medicine Connectome Humans Gait Disorders Neurologic Aged Supplementary motor area business.industry Motor Cortex Neurological Rehabilitation Parkinson Disease Middle Aged SMA medicine.disease Combined Modality Therapy Magnetic Resonance Imaging Transcranial Magnetic Stimulation Exercise Therapy Transcranial magnetic stimulation 030104 developmental biology medicine.anatomical_structure Neurology Orbitofrontal cortex Female Neurology (clinical) Geriatrics and Gerontology business 030217 neurology & neurosurgery |
| Zdroj: | Parkinsonism Relat Disord |
| ISSN: | 1873-5126 |
| Popis: | INTRODUCTION: Freezing of gait (FOG) is a debilitating feature of Parkinson’s disease (PD). Evidence suggests patients with FOG have increased cortical control of gait. The supplementary motor area (SMA) may be a key structure due to its connectivity with locomotor and cognitive networks. The objectives of this study were to determine (1) if SMA connectivity is disrupted in patients with FOG and (2) if “inhibitory” repetitive transcranial magnetic stimulation can decrease maladaptive SMA connectivity. METHODS: Two experiments were performed. In experiment 1 resting-state (T2* BOLD imaging) was compared between 38 PD freezers and 17 PD controls. In experiment 2, twenty PD patients with FOG were randomized to either 10 sessions of real or sham rTMS to the SMA (1 Hz, 110% motor threshold, 1200 pulses/session) combined with daily gait training. RESULTS: (Experiment 1) Freezers had increased connectivity between the left SMA and the vermis of the cerebellum and decreased connectivity between the SMA and the orbitofrontal cortex (p(FDR-corr) |
| Databáze: | OpenAIRE |
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