Internally Guided Lower Limb Movement Recruits Compensatory Cerebellar Activity in People With Parkinson's Disease

Bibliographic Details
Title: Internally Guided Lower Limb Movement Recruits Compensatory Cerebellar Activity in People With Parkinson's Disease
Authors: Jonathan H. Drucker, K. Sathian, Bruce Crosson, Venkatagiri Krishnamurthy, Keith M. McGregor, Ariyana Bozzorg, Kaundinya Gopinath, Lisa C. Krishnamurthy, Steven L. Wolf, Ariel R. Hart, Marian Evatt, Daniel M. Corcos, Madeleine E. Hackney
Source: Frontiers in Neurology, Vol 10 (2019)
Publisher Information: Frontiers Media S.A., 2019.
Publication Year: 2019
Collection: LCC:Neurology. Diseases of the nervous system
Subject Terms: Parkinson's, putamen, cerebellum, lower limb, internally guided, externally guided, Neurology. Diseases of the nervous system, RC346-429
More Details: Background: Externally guided (EG) and internally guided (IG) movements are postulated to recruit two parallel neural circuits, in which motor cortical neurons interact with either the cerebellum or striatum via distinct thalamic nuclei. Research suggests EG movements rely more heavily on the cerebello-thalamo-cortical circuit, whereas IG movements rely more on the striato-pallido-thalamo-cortical circuit (1). Because Parkinson's (PD) involves striatal dysfunction, individuals with PD have difficulty generating IG movements (2).Objectives: Determine whether individuals with PD would employ a compensatory mechanism favoring the cerebellum over the striatum during IG lower limb movements.Methods: 22 older adults with mild-moderate PD, who had abstained at least 12 h from anti-PD medications, and 19 age-matched controls performed EG and IG rhythmic foot-tapping during functional magnetic resonance imaging. Participants with PD tapped with their right (more affected) foot. External guidance was paced by a researcher tapping participants' ipsilateral 3rd metacarpal in a pattern with 0.5 to 1 s intervals, while internal guidance was based on pre-scan training in the same pattern. BOLD activation was compared between tasks (EG vs. IG) and groups (PD vs. control).Results: Both groups recruited the putamen and cerebellar regions. The PD group demonstrated less activation in the striatum and motor cortex than controls. A task (EG vs. IG) by group (PD vs. control) interaction was observed in the cerebellum with increased activation for the IG condition in the PD group.Conclusions: These findings support the hypothesized compensatory shift in which the dysfunctional striatum is assisted by the less affected cerebellum to accomplish IG lower limb movement in individuals with mild-moderate PD. These findings are of relevance for temporal gait dysfunction and freezing of gait problems frequently noted in many people with PD and may have implications for future therapeutic application.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1664-2295
Relation: https://www.frontiersin.org/article/10.3389/fneur.2019.00537/full; https://doaj.org/toc/1664-2295
DOI: 10.3389/fneur.2019.00537
Access URL: https://doaj.org/article/d885f229223b45fab77d96be31426efa
Accession Number: edsdoj.885f229223b45fab77d96be31426efa
Database: Directory of Open Access Journals
More Details
ISSN:16642295
DOI:10.3389/fneur.2019.00537
Published in:Frontiers in Neurology
Language:English