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Brain plasticity in Parkinson’s disease with freezing of gait induced by action observation training
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Brain plasticity in Parkinson’s disease with freezing of gait induced by action observation training
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Journal Article
Brain plasticity in Parkinson’s disease with freezing of gait induced by action observation training
2017
Overview
Gait disorders represent a therapeutic challenge in Parkinson’s disease (PD). This study investigated the efficacy of 4-week action observation training (AOT) on disease severity, freezing of gait and motor abilities in PD, and evaluated treatment-related brain functional changes. 25 PD patients with freezing of gait were randomized into two groups: AOT (action observation combined with practicing the observed actions) and “Landscape” (same physical training combined with landscape-videos observation). At baseline and 4-week, patients underwent clinical evaluation and fMRI. Clinical assessment was repeated at 8-week. At 4-week, both groups showed reduced freezing of gait severity, improved walking speed and quality of life. Moreover, AOT was associated with reduced motor disability and improved balance. AOT group showed a sustained positive effect on motor disability, walking speed, balance and quality of life at 8-week, with a trend toward a persisting reduced freezing of gait severity. At 4-week vs. baseline, AOT group showed increased recruitment of fronto-parietal areas during fMRI tasks, while the Landscape group showed a reduced fMRI activity of the left postcentral and inferior parietal gyri and right rolandic operculum and supramarginal gyrus. In AOT group, functional brain changes were associated with clinical improvements at 4-week and predicted clinical evolution at 8-week. AOT has a more lasting effect in improving motor function, gait and quality of life in PD patients relative to physical therapy alone. AOT-related performance gains are associated with an increased recruitment of motor regions and fronto-parietal mirror neuron and attentional control areas.
Publisher
Springer Berlin Heidelberg,Springer Nature B.V
Subject
/ Female
/ Gait
/ Gait Disorders, Neurologic - diagnostic imaging
/ Gait Disorders, Neurologic - physiopathology
/ Gait Disorders, Neurologic - psychology
/ Gait Disorders, Neurologic - rehabilitation
/ Humans
/ Male
/ Medicine
/ Motion Perception - physiology
/ Neuronal Plasticity - physiology
/ Parkinson Disease - diagnostic imaging
/ Parkinson Disease - physiopathology
/ Parkinson Disease - psychology
/ Parkinson Disease - rehabilitation
