1. Enhancing balance in Parkinson’s disease patients : a comprehensive literature review on the efficacy of exercise in an enriched environmentAna Ponebšek, Friderika Kresal, Luka Šlosar, 2023, review article Abstract: Various physiotherapeutic methods and approaches play a significant role in the
treatment of patients with Parkinson’s disease, including the use of enriched environments. Virtual reality (VR) as a type of enriched environment has the potential to create
multiple sensory experiences and feedback, influencing various aspects of the patient’s
information processing and response. The suitability for home use and the considerable impact on motivation highlight its advantages over alternative approaches. The
objective of this review is to investigate the impact of VR-based exercise on balance
outcomes among individuals with Parkinson’s disease. The inclusion criteria consisted Parkinson’s disease. The comparable improvements in balance observed between the
experimental and control groups signify the potential effectiveness of VR-based exercises. This underscores the encouragement for further development in this technology,
particularly focusing on fully immersive VR environments, which may yield superior
effects in enhancing balance among individuals with Parkinson’s disease.
of randomized controlled trials (RCTs) that examined the effects of exercise in a VR
environment on individuals’ static and dynamic balance outcomes. In order to gather
relevant studies, we conducted a comprehensive search across three databases. From a
dataset of 625 records, we conducted a comprehensive full-text screening based on specific inclusion and exclusion criteria. This process resulted in the inclusion of 14 RCTs
in our review. The emerging evidence regarding exercising in a VR environment does
not definitively prove its superiority over standard exercise routines. However, studies
have demonstrated that both the experimental and control groups showed comparable improvements in enhancing static and dynamic balance among individuals with
Keywords: virtual reality, Parkinson's disease, balance, rehabilitation
Published in DiRROS: 16.04.2024; Views: 37; Downloads: 14
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2. 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: 80; Downloads: 44
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3. 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: 344; Downloads: 150
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4. Brain dynamics underlying preserved cycling ability in patients with Parkinson’s disease and freezing of gaitTeja Ličen, Martin Rakuša, Nicolaas I. Bohnen, Paolo Manganotti, Uroš Marušič, 2022, review article 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.
Keywords: gait, freezing of gait, Parkinson's disease, cycling, cortical oscillations, beta band
Published in DiRROS: 21.06.2022; Views: 551; Downloads: 440
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