TY - JOUR
T1 - Effects of exercise on gait and motor imagery in people with Parkinson disease and freezing of gait
AU - Myers, Peter S.
AU - McNeely, Marie E.
AU - Pickett, Kristen A.
AU - Duncan, Ryan P.
AU - Earhart, Gammon M.
N1 - Funding Information:
We thank all members of the Movement Science Research Center and the Neuroimaging Laboratory for their contributions to data collection and analyses, including Martha J. Hessler and Richard G. Nagel. We are especially grateful to our participants and their care partners. This work was supported by the National Institutes of Health [ NICHD T32HD007434 , NINDS R01NS077959 ]; the Greater St. Louis Chapter of the American Parkinson Disease Association (APDA) ; Parkinson Study Group and the Parkinson's Disease Foundation's Advancing Parkinson's Treatments Innovations Grant ; and the APDA Center for Advanced Parkinson Disease Research at Washington University in St. Louis .
Funding Information:
We thank all members of the Movement Science Research Center and the Neuroimaging Laboratory for their contributions to data collection and analyses, including Martha J. Hessler and Richard G. Nagel. We are especially grateful to our participants and their care partners. This work was supported by the National Institutes of Health [NICHD T32HD007434, NINDS R01NS077959]; the Greater St. Louis Chapter of the American Parkinson Disease Association (APDA); Parkinson Study Group and the Parkinson's Disease Foundation's Advancing Parkinson's Treatments Innovations Grant; and the APDA Center for Advanced Parkinson Disease Research at Washington University in St. Louis.
Funding Information:
We thank all members of the Movement Science Research Center and the Neuroimaging Laboratory for their contributions to data collection and analyses, including Martha J. Hessler and Richard G. Nagel. We are especially grateful to our participants and their care partners. This work was supported by the National Institutes of Health [NICHD T32HD007434, NINDS R01NS077959, NIH K12 HD055931, NIH UL1 TR00048]; the Greater St. Louis Chapter of the American Parkinson Disease Association (APDA); Parkinson Study Group and the Parkinson's Disease Foundation's Advancing Parkinson's Treatments Innovations Grant; and the APDA Center for Advanced Parkinson Disease Research at Washington University in St. Louis.
Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2018/8
Y1 - 2018/8
N2 - Introduction: Exercise improves gait in Parkinson disease (PD), but whether exercise differentially affects people with PD with (freezers) and without freezing of gait (non-freezers) remains unclear. This study examines exercise's effects on gait performance, neural correlates related to these effects, and potential neural activation differences between freezers and non-freezers during motor imagery (MI) of gait. Methods: Thirty-seven participants from a larger exercise intervention completed behavioral assessments and functional magnetic resonance imaging (fMRI) scans before and after a 12-week exercise intervention. Gait performance was characterized using gait velocity and stride length, and a region of interest (ROI) fMRI analysis examined task-based blood oxygen-level dependent (BOLD) signal changes of the somatomotor network (SMN) during MI of forward (IMG-FWD) and backward (IMG-BWD) gait. Results: Velocity (F(1,34) = 55.04, p < 0.001) and stride length (F(1,34) = 77.58, p < 0.001) were significantly lower for backward versus forward walking in all participants. The ROI analysis showed freezers had lower BOLD signal compared to non-freezers in the cerebellum (F(1,32) = 7.01, p = 0.01), primary motor (left: F(1,32) = 7.09, p = 0.01; right: F(1,32) = 7.45, p = 0.01), and primary sensory (left: F(1,32) = 9.59, p = 0.004; right: F(1,32) = 8.18, p = 0.007) cortices during IMG-BWD only. The evidence suggests the exercise intervention did not affect gait or BOLD signal during MI. Conclusion: While all participants had significantly slower and shorter backward velocity and stride length, respectively, the exercise intervention had no effect. Similarly, BOLD signal during MI did not change with exercise; however, freezers had significantly lower BOLD signal during IMG-BWD compared to non-freezers. This suggests potential decreased recruitment of the SMN during MI of gait in freezers.
AB - Introduction: Exercise improves gait in Parkinson disease (PD), but whether exercise differentially affects people with PD with (freezers) and without freezing of gait (non-freezers) remains unclear. This study examines exercise's effects on gait performance, neural correlates related to these effects, and potential neural activation differences between freezers and non-freezers during motor imagery (MI) of gait. Methods: Thirty-seven participants from a larger exercise intervention completed behavioral assessments and functional magnetic resonance imaging (fMRI) scans before and after a 12-week exercise intervention. Gait performance was characterized using gait velocity and stride length, and a region of interest (ROI) fMRI analysis examined task-based blood oxygen-level dependent (BOLD) signal changes of the somatomotor network (SMN) during MI of forward (IMG-FWD) and backward (IMG-BWD) gait. Results: Velocity (F(1,34) = 55.04, p < 0.001) and stride length (F(1,34) = 77.58, p < 0.001) were significantly lower for backward versus forward walking in all participants. The ROI analysis showed freezers had lower BOLD signal compared to non-freezers in the cerebellum (F(1,32) = 7.01, p = 0.01), primary motor (left: F(1,32) = 7.09, p = 0.01; right: F(1,32) = 7.45, p = 0.01), and primary sensory (left: F(1,32) = 9.59, p = 0.004; right: F(1,32) = 8.18, p = 0.007) cortices during IMG-BWD only. The evidence suggests the exercise intervention did not affect gait or BOLD signal during MI. Conclusion: While all participants had significantly slower and shorter backward velocity and stride length, respectively, the exercise intervention had no effect. Similarly, BOLD signal during MI did not change with exercise; however, freezers had significantly lower BOLD signal during IMG-BWD compared to non-freezers. This suggests potential decreased recruitment of the SMN during MI of gait in freezers.
KW - Cerebellum
KW - Freezing of gait
KW - Neuroimaging
KW - Parkinson disease
UR - http://www.scopus.com/inward/record.url?scp=85046748258&partnerID=8YFLogxK
U2 - 10.1016/j.parkreldis.2018.05.006
DO - 10.1016/j.parkreldis.2018.05.006
M3 - Article
C2 - 29754837
AN - SCOPUS:85046748258
SN - 1353-8020
VL - 53
SP - 89
EP - 95
JO - Parkinsonism and Related Disorders
JF - Parkinsonism and Related Disorders
ER -