Soft robotic apparel to avert freezing of gait in Parkinson’s disease

Nature Medicine, Journal Year: 2024, Volume and Issue: 30(1), P. 177 - 185

Published: Jan. 1, 2024

Language: Английский

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Cortical phase-amplitude coupling is key to the occurrence and treatment of freezing of gait

Brain, Journal Year: 2022, Volume and Issue: 145(7), P. 2407 - 2421

Published: March 29, 2022

Abstract Freezing of gait is a debilitating symptom in advanced Parkinson’s disease and responds heterogeneously to treatments such as deep brain stimulation. Recent studies indicated that cortical dysfunction involved the development freezing, while evidence depicting specific role primary motor cortex multi-circuit pathology freezing lacking. Since abnormal beta-gamma phase-amplitude coupling recorded from patients with indicates parkinsonian state responses therapeutic stimulation, we hypothesized this metric might reveal unique information on understanding improving therapy for gait. Here, directly potentials using subdural electrocorticography synchronously captured optoelectronic motion-tracking systems 16 freely-walking who received subthalamic nucleus stimulation surgery. Overall, 451 timed up-and-go walking trials quantified 7073 s stable 3384 conditions on/off-stimulation with/without dual-tasking. We found (i) high was detected (i.e. contained freezing), but not non-freezing trials, caused by dual-tasking or lack movement; (ii) episodes within also demonstrated abnormally couplings, which predicted severity; (iii) reduced these couplings simultaneously improved freezing; (iv) were at similar levels, still lower severity than no-stimulation trials. These findings suggest elevated higher probabilities freezing. Therapeutic alleviates both decoupling oscillations enhancing resistance coupling. formalized novel ‘bandwidth model,’ specifies dysfunction, cognitive burden emergence By targeting key elements model, may develop next-generation approaches

Language: Английский

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Could adaptive deep brain stimulation treat freezing of gait in Parkinson’s disease?

Journal of Neurology, Journal Year: 2025, Volume and Issue: 272(4)

Published: March 12, 2025

Abstract Next-generation neurostimulators capable of running closed-loop adaptive deep brain stimulation (aDBS) are about to enter the clinical landscape for treatment Parkinson’s disease. Already promising results using aDBS have been achieved symptoms such as bradykinesia, rigidity and motor fluctuations. However, heterogeneity freezing gait (FoG) with its wide range presentations exacerbation cognitive emotional load make it more difficult predict treat. Currently, a successful strategy ameliorate FoG lacks robust oscillatory biomarker. Furthermore, technical implementation suppressing an upcoming episode in real-time represents significant challenge. This review describes neurophysiological signals underpinning explains how is currently being implemented. we offer discussion addressing both theoretical practical areas that will need be resolved if going able unlock full potential treat FoG.

Language: Английский

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Management of freezing of gait — mechanism-based practical recommendations

Nature Reviews Neurology, Journal Year: 2025, Volume and Issue: unknown

Published: April 1, 2025

Language: Английский

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Stepping up to meet the challenge of freezing of gait in Parkinson’s disease

Translational Neurodegeneration, Journal Year: 2022, Volume and Issue: 11(1)

Published: May 1, 2022

Abstract There has been a growing appreciation for freezing of gait as disabling symptom that causes significant burden in Parkinson’s disease. Previous research highlighted some the key components underlie phenomenon, but these reductionist approaches have yet to lead paradigm shift resulting development novel treatment strategies. Addressing this issue will require greater integration multi-modal data with complex computational modeling, there are number critical aspects need be considered before embarking on such an approach. This paper highlights where field needs address current gaps and shortcomings including standardization definitions measurement, phenomenology pathophysiology, well considering what available exist how future studies should constructed achieve greatest potential better understand treat devastating symptom.

Language: Английский

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Interventions to improve gait in Parkinson’s disease: a systematic review of randomized controlled trials and network meta-analysis

Journal of Neurology, Journal Year: 2022, Volume and Issue: 269(8), P. 4068 - 4079

Published: April 5, 2022

Language: Английский

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Levodopa responsive freezing of gait is associated with reduced norepinephrine transporter binding in Parkinson's disease

Neurobiology of Disease, Journal Year: 2023, Volume and Issue: 179, P. 106048 - 106048

Published: Feb. 21, 2023

Freezing of gait (FOG) is a major cause falling in Parkinson's disease (PD) and can be responsive or unresponsive to levodopa. Pathophysiology poorly understood.To examine the link between noradrenergic systems, development FOG PD its responsiveness levodopa.We examined norepinephrine transporter (NET) binding via brain positron emission tomography (PET) evaluate changes NET density associated with using high affinity selective antagonist radioligand [11C]MeNER (2S,3S)(2-[α-(2-methoxyphenoxy)benzyl]morpholine) 52 parkinsonian patients. We used rigorous levodopa challenge paradigm characterize patients as non-freezing (NO-FOG, N = 16), freezing (OFF-FOG, 10), levodopa-unresponsive (ONOFF-FOG, 21), also included non-PD group, primary progressive (PP-FOG, 5).Linear mixed models identified significant reductions whole OFF-FOG group compared NO-FOG (-16.8%, P 0.021) regionally frontal lobe, left right thalamus, temporal locus coeruleus, strongest effect thalamus (P 0.038). Additional regions post hoc secondary analysis including amygdalae confirmed contrast 0.003). A linear regression an association reduced more severe New Questionnaire (N-FOG-Q) score only 0.022).This first study innervation NET-PET without FOG. Based on normal regional distribution pathological studies patients, implications our findings suggest that limbic pathways may play key role PD. This finding could have for clinical subtyping well therapies.

Language: Английский

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An fNIRS-Based Dynamic Functional Connectivity Analysis Method to Signify Functional Neurodegeneration of Parkinson’s Disease

IEEE Transactions on Neural Systems and Rehabilitation Engineering, Journal Year: 2023, Volume and Issue: 31, P. 1199 - 1207

Published: Jan. 1, 2023

Parkinson's disease (PD) is a prevalent brain disorder, and PD diagnosis crucial for treatment. Existing methods are mainly focused on behavior analysis, while the functional neurodegeneration of has not been well investigated. This paper proposes method to signify with dynamic connectivity analysis. A near-infrared spectroscopy (fNIRS)-based experimental paradigm was designed capture activation from 50 patients 41 age-matched healthy controls in clinical walking tests. Dynamic constructed sliding-window correlation k-means clustering applied generate key states. state features including occurrence probability, transition percentage statistical were extracted quantify variations networks. support vector machine trained classify controls. Statistical analysis conducted investigate difference between as relationship MDS-UPDRS sub-score gait. The results showed that had higher probability transiting states high levels information transmission compared gait dynamics significant correlation. Moreover, proposed better classification performances than available fNIRS-based terms accuracy F1 score. Thus, signified PD, may serve promising biomarkers diagnosis.

Language: Английский

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Neurobiological mechanism of music improving gait disorder in patients with Parkinson’s disease: a mini review

Frontiers in Neurology, Journal Year: 2025, Volume and Issue: 15

Published: Jan. 3, 2025

Walking ability is essential for human survival and health. Its basic rhythm mainly generated by the central pattern generator of spinal cord. The rhythmic stimulation music to auditory center affects cerebral cortex other higher nerve centers, acts on generator. By means entrainment, can produce walking synchronized with rhythm, control muscle tension, then regulate gait. Basal ganglia dysfunction main cause abnormal gait in patients Parkinson's disease. Music therapy provides external stimulation, recruits neural networks bypass basal synchronizes rhythms both time space through auditory-motor networks, helping promote improvement patterns

Language: Английский

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A possible pathway to freezing of gait in Parkinson's disease

Journal of Parkinson s Disease, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 14, 2025

Freezing of gait (FOG), a common, perplexing disorder observed in Parkinson's disease (PD), is leading cause injurious falls and contributes significantly to social isolation. Unlike other PD cardinal features, FOG appears develop independently, its heterogeneity presents challenges for both definition measurement. The pathophysiological mechanisms underlying remain poorly understood, limiting the development effective treatments. Although roles specific, targetable biomarkers unidentified, evidence suggests that it likely multimodal, potentially involving extranigral transmitter circuits. diversity phenotypes may also reflect differences pathophysiology. In this paper, we first present occur independently dopaminergic influence. We then review an expanding body research supporting hypothesis arises from dysfunctional feedback loop, norepinephrine (NE) depletion, neuroinflammation, amyloid-β (Aβ) accumulation. This biological disruption occurs concurrently with, but distinct from, primary pathology PD. When they on background dopamine loss, interactions between NE, Aβ, inflammation, as Alzheimer's models, similarly play critical role could serve pathobiological markers. proposed changes loop might even precede onset, highlighting need further investigation. A deeper understanding involvement inflammatory markers pave way rapid clinical trials test existing amyloid-clearing therapies noradrenergic drugs appropriate patient populations.

Language: Английский

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