1. Dynamic balance and gait impairments in Parkinson’s disease : novel cholinergic patternsNicolaas I. Bohnen, Uroš Marušič, Stiven Roytman, Rebecca Paalanen, Fotini Michalakis, Taylor Brown, Peter J. H. Scott, Giulia Carli, Roger Albin, Prabesh Kanel, 2024, original scientific article Abstract: The cholinergic system has been implicated in postural deficits, in particular falls, in Parkinson’s disease.
Falls and freezing of gait typically occur during dynamic and challenging balance and gait conditions,
such as when initiating gait, experiencing postural perturbations, or making turns. However, the precise
cholinergic neural substrate underlying dynamic postural and gait changes remains poorly understood.
The aim of this study was to investigate whether brain vesicular acetylcholine transporter binding, as
measured with [18F]-fluoroethoxybenzovesamicolbinding PET, correlates with dynamic gait and balance
impairments in 125 patients with Parkinson’s disease (mean age 66.89±7.71 years) using the abbreviated
Balance Evaluation Systems Test total and its four functional domain sub-scores (anticipatory postural
control, reactive postural control, dynamic gait, and sensory integration). Whole brain false discoverycorrected (P < 0.05) correlations for total abbreviated Balance Evaluation Systems Test scores included
the following bilateral or asymmetric hemispheric regions: gyrus rectus, orbitofrontal cortex, anterior part
of the dorsomedial prefrontal cortex, dorsolateral prefrontal cortex, cingulum, frontotemporal opercula,
insula, fimbria, right temporal pole, mesiotemporal, parietal and visual cortices, caudate nucleus, lateral
and medial geniculate bodies, thalamus, lingual gyrus, cerebellar hemisphere lobule VI, left cerebellar
crus I, superior cerebellar peduncles, flocculus, and nodulus. No significant correlations were found for
the putamen or anteroventral putamen. The four domain-specific sub-scores demonstrated overlapping
cholinergic topography in the metathalamus, fimbria, thalamus proper, and prefrontal cortices but also
showed distinct topographic variations. For example, reactive postural control functions involved the right
flocculus but not the upper brainstem regions. The anterior cingulum associated with reactive postural
control whereas the posterior cingulum correlated with anticipatory control. The spatial extent of
associated cholinergic system changes were least for dynamic gait and sensory orientation functional
domains compared to the anticipatory and reactive postural control functions. We conclude that specific
aspects of dynamic balance and gait deficits in Parkinson’s disease associate with overlapping but also
distinct patterns of cerebral cholinergic system changes in numerous brain regions. Our study also presents
novel evidence of cholinergic topography involved in dynamic balance and gait in Parkinson’s disease
that have not been typically associated with mobility disturbances, such as the right anterior temporal pole,
right anterior part of the dorsomedial prefrontal cortex, gyrus rectus, fimbria, lingual gyrus, flocculus,
nodulus and right cerebellar hemisphere lobules VI and left crus I. Keywords: Parkinson’s disease, dynamic balance, cholinergic, PET Published in DiRROS: 30.08.2024; Views: 169; Downloads: 457 Full text (4,32 MB) This document has many files! More... |
2. Computerized cognitive training in the older workforce : effects on cognition, life satisfaction, and productivityZdenka Milič Žepič, Voyko Kavcic, Bruno Giordani, Uroš Marušič, 2024, original scientific article Abstract: Background: The accelerated aging of the world’s population will lead to an increase in the number of older people in the workforce. Computerized Cognitive Training (CCT) is effective in improving cognitive outcomes, but its benefits for older workers remain controversial. We investigate the real-world efficacy of CCT in the workplace, focusing on employees aged 50+ years from a public sector agency. Methods: Case managers (n = 82) were randomized to either an intervention group (24 40 min CCT sessions two times per week) or a waiting list passive control group. Cognitive ability, well-being, job satisfaction, and productivity outcome measures were collected and assessed before and after CCT or the comparable control wait time. Results: Participants undergoing CCT improved on a task of executive functioning (p = 0.04). There was a trend toward a change in work productivity after CCT (p = 0.09), with the control group showing a significant decrease (p = 0.02), while the intervention group remained stable. Conclusions: CCT during office hours has a positive effect on cognition and well-being without affecting productivity among white-collar office workers. CCT could be considered as an intervention to support the older workforce in managing the cognitive and behavioral challenges of changing workplace demands. Keywords: older employees, 50+, computerized cognitive training (CCT), productivity, well-being Published in DiRROS: 05.08.2024; Views: 230; Downloads: 289 Full text (1,55 MB) This document has many files! More... |
3. Multisensory mechanisms of gait and balance in Parkinson's disease : an integrative reviewStiven Roytman, Rebecca Paalanen, Giulia Carli, Uroš Marušič, Prabesh Kanel, Teus van Laar, Nicolaas I. Bohnen, 2025, review article Abstract: Understanding the neural underpinning of human gait and balance is one of the most pertinent challenges for 21st-century translational neuroscience due to the profound impact that falls and mobility disturbances have on our aging population. Posture and gait control does not happen automatically, as previously believed, but rather requires continuous involvement of central nervous mechanisms. To effectively exert control over the body, the brain must integrate multiple streams of sensory information, including visual, vestibular, and somatosensory signals. The mechanisms which underpin the integration of these multisensory signals are the principal topic of the present work. Existing multisensory integration theories focus on how failure of cognitive processes thought to be involved in multisensory integration leads to falls in older adults. Insufficient emphasis, however, has been placed on specific contributions of individual sensory modalities to multisensory integration processes and cross-modal interactions that occur between the sensory modalities in relation to gait and balance. In the present work, we review the contributions of somatosensory, visual, and vestibular modalities, along with their multisensory intersections to gait and balance in older adults and patients with Parkinson's disease. We also review evidence of vestibular contributions to multisensory temporal binding windows, previously shown to be highly pertinent to fall risk in older adults. Lastly, we relate multisensory vestibular mechanisms to potential neural substrates, both at the level of neurobiology (concerning positron emission tomography imaging) and at the level of electrophysiology (concerning electroencephalography). We hope that this integrative review, drawing influence across multiple subdisciplines of neuroscience, paves the way for novel research directions and therapeutic neuromodulatory approaches, to improve the lives of older adults and patients with neurodegenerative diseases. Keywords: aging, gait, balance, encephalography, functional magnetic resonance imaging, multisensory integration Published in DiRROS: 17.06.2024; Views: 302; Downloads: 324 Full text (1,36 MB) This document has many files! More... |
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6. Efects of chronic physical exercise on executive functions and episodic memory in clinical and healthy older adult populations : a systematic review and meta-analysis protocolSoledad Ballesteros, Andreea Badache, Vera Belkin, Christoforos D. Giannaki, Antonia Kaltsatou, Uroš Marušič, Mohammad Mosaferi Ziaaldini, Manca Peskar, José M. Reales, Jennifer A. Rieker, 2024, review article Abstract: Background Executive functions (EFs) and episodic memory are fundamental components of cognition that deteriorate with age and are crucial for independent living. While numerous reviews have explored the effect of exercise on these components in old age, these reviews screened and analyzed selected older adult populations, or specific exercise modes, thus providing only limited answers to the fundamental question on the effect of exercise on cognition in old age. This article describes the protocol for a systematic review and multilevel meta-analytic study aiming at evaluating the effectiveness of different types of chronic exercise in improving and/or maintaining EFs and long-term episodic memory in older adults. Methods and analysis The study protocol was written in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Several databases will be searched. Randomized controlled trials (RCTs) conducted in older adults aged ≥ 60 years providing any kind of planned, structured, and repetitive exercise interventions, and EFs and/or episodic memory measures as outcomes, published in English in peer-reviewed journals and doctoral dissertations will be included. Two independent reviewers will screen the selected articles, while a third reviewer will resolve possible conflicts. The Cochrane risk-of-bias tool will be used to assess the quality of the studies. Finally, data will be extracted from the selected articles, and the formal method of combining individual data from the selected studies will be applied using a random effect multilevel meta-analysis. The data analysis will be conducted with the metafor package in R. Discussion and conclusion This review will synthesize the existing evidence and pinpoint gaps existing in the literature on the effects of exercise on EFs and episodic memory in healthy and unhealthy older adults. Findings from this meta-analysis will help to design effective exercise interventions for older adults to improve and/or maintain EFs and episodic memory. Its results will be useful for many researchers and professionals working with older adults and their families. Keywords: diseased older adults, healthy older adultsi, episodic memory, executive functions, exercises, three level meta analysis, tri-nivojska meta-analiza Published in DiRROS: 03.04.2024; Views: 528; Downloads: 237 Full text (1,18 MB) This document has many files! More... |
7. Beta–gamma phase-amplitude coupling as a non-invasive biomarker for Parkinson’s diseas : insights from Electroencephalography studiesTisa Hodnik, Stiven Roytman, Nicolaas I. Bohnen, Uroš Marušič, 2024, review article Abstract: Phase-amplitude coupling (PAC) describes the interaction of two separate frequencies in which the lower frequency phase acts as a carrier frequency of the higher frequency amplitude. It is a means of carrying integrated streams of information between micro- and macroscale systems in the brain, allowing for coordinated activity of separate brain regions. A beta–gamma PAC increase over the sensorimotor cortex has been observed consistently in people with Parkinson’s disease (PD). Its cause is attributed to neural entrainment in the basal ganglia, caused by pathological degeneration characteristic of PD. Disruptions in this phenomenon in PD patients have been observed in the resting state as well as during movement recordings and have reliably distinguished patients from healthy participants. The changes can be detected non-invasively with the electroencephalogram (EEG). They correspond to the severity of the motor symptoms and the medication status of people with PD. Furthermore, a medication-induced decrease in PAC in PD correlates with the alleviation of motor symptoms measured by assessment scales. A beta–gamma PAC increase has, therefore, been explored as a possible means of quantifying motor pathology in PD. The application of this parameter to closed-loop deep brain stimulation could serve as a self-adaptation measure of such treatment, responding to fluctuations of motor symptom severity in PD. Furthermore, phase-dependent stimulation provides a new precise method for modulating PAC increases in the cortex. This review offers a comprehensive synthesis of the current EEG-based evidence on PAC fluctuations in PD, explores the potential practical utility of this biomarker, and provides recommendations for future research. Keywords: neurodegenerative diseases, Parkinson’s disease, electroencephalography, phase-amplitude coupling Published in DiRROS: 21.03.2024; Views: 474; Downloads: 214 Full text (604,09 KB) This document has many files! More... |
8. Editorial : The intersection of cognitive, motor, and sensory processing in agingsUroš Marušič, Jeannette R. Mahoney, 2024, other scientific articles Keywords: aging, sensory performance, motor performance, cognitive performance, multisensory integration Published in DiRROS: 22.01.2024; Views: 503; Downloads: 188 Full text (119,17 KB) This document has many files! More... |
9. Participation in youth sports influences sarcopenia parameters in older adultsKaja Teraž, Miloš Kalc, Boštjan Šimunič, Uroš Marušič, Primož Pori, Saša Pišot, Rado Pišot, 2023, original scientific article Abstract: Background The degree of deterioration in sarcopenia parameters may be affected by a person’s level of physical activity (PA) and sedentary behavior (SB). Our study focused on examining the PA and SB of active older adults including those with and without history of sports in youth. Methods Forty-four participants (20 men and 24 women, mean age of total sample 76.1 ± 5.2 years) were included in analysis of PA, SB habits and sarcopenia parameters, determined by skeletal muscle index, hand-grip strength, gait speed, Timed Up and Go tests (TUG). PA and SB were recorded with accelerometers. Our primary aim was to compare participants with (AH) or without a sport history in youth (NAH), in their sarcopenia parameters and PA and SB habits. Results When divided participants in two groups (AH and NAH) and adjusting for age, we have detected the differences for skeletal muscle index (p = 0.007) and hand-grip strength (p = 0.004) in favor of participants who were engaged in sports in youth. We did not find any differences in PA and SB habits between the AH and NAH groups. After adjusting for age, participants with a higher number of daily steps, longer moderate to vigorous physical activity (MVPA) bouts, a higher number of MVPA bouts in a day and higher overall MVPA engagement achieved better results in hand-grip strength and TUG. Participants with lower SB had better TUG and gait speed results. Conclusions Our findings suggest that engaging in sports activities in youth can make a difference with sarcopenia parameters. Although we found no differences in PA and SB habits between participants with AH and NAH, participants with an athlete history performed better results in sarcopenia parameters. Keywords: muscles, muscle disorder, elderly, exercise, sedentarism Published in DiRROS: 10.11.2023; Views: 613; Downloads: 1590 Full text (1,04 MB) This document has many files! More... |
10. Neuromuscular assessment of force development, postural, and gait performance under cognitive-motor dual-tasking in healthy older adults and early Parkinson's disease patients : study protocol for a cross-sectional Mobile Brain/Body Imaging (MoBI) studyUroš Marušič, Manca Peskar, Maja Maša Šömen, Miloš Kalc, Aleš Holobar, Klaus Gramann, Bettina Wollesen, Anna Wunderlich, Christoph M. Michel, Aleksandar Miladinović, Mauro Catalan, Alex B. Stella, Miloš Ajčević, Paolo Manganotti, 2023, original scientific article Abstract: Background: Neuromuscular dysfunction is common in older adults and more pronounced in neurodegenerative diseases. In Parkinson's disease (PD), a complex set of factors often prevents the effective performance of activities of daily living that require intact and simultaneous performance of the motor and cognitive tasks. Methods: The cross-sectional study includes a multifactorial mixed-measure design. Between-subject factor grouping the sample will be Parkinson’s Disease (early PD vs. healthy). The within-subject factors will be the task complexity (single- vs. dual-task) in each motor activity, i.e., overground walking, semi-tandem stance, and isometric knee extension, and a walking condition (wide vs. narrow lane) will be implemented for the overground walking activity only. To study dual-task (DT) effects, in each motor activity participants will be given a secondary cognitive task, i.e., a visual discrimination task for the overground walking, an attention task for the semi-tandem, and mental arithmetic for the isometric extension. Analyses of DT effects and underlying neuronal correlates will focus on both gait and cognitive performance where applicable. Based on an a priori sample size calculation, a total N = 42 older adults (55-75 years) will be recruited. Disease-specific changes such as laterality in motor unit behavior and cortical control of movement will be studied with high-density surface electromyography and electroencephalography during static and dynamic motor activities, together with whole-body kinematics. Discussion: This study will be one of the first to holistically address early PD neurophysiological and neuromuscular patterns in an ecologically valid environment under cognitive-motor DT conditions of different complexities. The outcomes of the study aim to identify the biomarker for early PD either at the electrophysiological, muscular or kinematic level or in the communication between these systems. Keywords: Parkinson's disease, mobile brain imaging, body brain imaging, MoBi, dual tasking, neuromuscular function, older adults Published in DiRROS: 15.09.2023; Views: 678; Downloads: 302 Full text (1,36 MB) This document has many files! More... |