Modulation of Cutaneous Reflexes From the Foot During Gait in Parkinson's Disease

2010 ◽  
Vol 104 (1) ◽  
pp. 230-238 ◽  
Author(s):  
Jacques Duysens ◽  
Bart M. H. Van Wezel ◽  
Bouwien Smits-Engelsman
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Healthy Subjects ◽  
Biceps Femoris ◽  
Cutaneous Reflexes ◽  
Step Cycle ◽  
Reflex Responses ◽  
Cutaneous Reflex ◽  
Unsteady Gait ◽  
Fast Activation

Normal gait is characterized by a phase-dependent modulation of cutaneous reflexes. The role of the basal ganglia in regulating these reflexes is largely unknown. Therefore cutaneous reflex responses from the skin of the foot were studied during walking of patients with mild to moderate Parkinson's disease (PD). The reflex responses were elicited by stimulation of the sural nerve of the most affected leg. The responses were studied in the biceps femoris (BF) and tibialis anterior (TA) of both legs. The latencies, durations, and phase-dependent modulation patterns of the responses were mostly comparable with those observed in healthy subjects. However, on average the amplitude of the responses in the ipsilateral and contralateral BF was respectively 1.4- and 5-fold larger for the PD patients than that for the healthy subjects. This increase was mostly seen throughout the whole step cycle. However, in some PD patients the crossed BF responses were very large during the contralateral swing phase. In such cases the increase in crossed reflexes sometimes reflected premotoneuronal gating since it was not always due to increased background activation in that period. Fast activation of contralateral BF reflexes is known to occur in conjunction with ipsilateral perturbations when there is a threat to stability. It is concluded that cutanoeus reflexes are facilitated in PD but that some of the increase in reflexes in BF may be indirectly related to unsteady gait and to perceived instability.

scholarly journals Aβ Fibers Mediate Cutaneous Reflexes During Human Walking

2000 ◽  
Vol 83 (5) ◽  
pp. 2980-2986 ◽  
Author(s):  
B.M.H. van Wezel ◽  
B.G.M. van Engelen ◽  
F.J.M. Gabreëls ◽  
A.A.W.M. Gabreëls-Festen ◽  
J. Duysens
Keyword(s):  
Healthy Subjects ◽  
Biceps Femoris ◽  
Human Gait ◽  
Emg Activity ◽  
Cutaneous Reflexes ◽  
Step Cycle ◽  
Reflex Responses ◽  
Low Threshold ◽  
Two Phases ◽  
Aβ Fibers

During human gait, transmission of cutaneous reflexes from the foot is controlled specifically according to the phase of the step cycle. These reflex responses can be evoked by nonnociceptive stimuli, and therefore it is thought that the large-myelinated and low-threshold Aβ afferent fibers mediate these reflexes. At present, this hypothesis is not yet verified. To test whether Aβ fibers are involved the reflex responses were studied in patients with a sensory polyneuropathy who suffer from a predominant loss of large-myelinated Aβ fibers. The sural nerve of both patients and healthy control subjects was stimulated electrically at a nonnociceptive intensity during the early and late swing phases while they walked on a treadmill. The responses were studied by recording electromyographic (EMG) activity of the biceps femoris (BF) and tibialis anterior (TA) of the stimulated leg. In both phases, large facilitatory responses were observed in the BF of the healthy subjects. These facilitations were reduced significantly in the BF of the patients, indicating that Aβ fibers mediate these reflexes. In TA similar results were obtained. The absolute response magnitude across the two phases was significantly smaller for the patients than for the healthy subjects. The TA responses for the healthy subjects were on average facilitatory during early swing and suppressive during end swing. Both facilitations and suppressions were considerably smaller for the patients, indicating that both types of responses are mediated by Aβ fibers. It is concluded that low-threshold Aβ sensory fibers mediate these reflexes during human gait. The low threshold and the precise phase-dependent control of these responses suggest that these responses are important in the regulation of gait. The loss of such reflex activity may be related to the gait impairments of these patients.

scholarly journals Relationship between Muscular Activity and Postural Control Changes after Proprioceptive Focal Stimulation (Equistasi®) in Middle-Moderate Parkinson’s Disease Patients: An Explorative Study

Sensors ◽  
2021 ◽  
Vol 21 (2) ◽  
pp. 560
Author(s):  
Fabiola Spolaor ◽  
Marco Romanato ◽  
Guiotto Annamaria ◽  
Antonella Peppe ◽  
Leila Bakdounes ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Control ◽  
Quantitative Estimation ◽  
Force Plate ◽  
Muscular Activity ◽  
Rectus Femoris ◽  
Biceps Femoris ◽  
Eyes Open ◽  
Romberg Test

The aim of this study was to investigate the effects of Equistasi®, a wearable device, on the relationship between muscular activity and postural control changes in a sample of 25 Parkinson’s disease (PD) subjects. Gait analysis was carried out through a six-cameras stereophotogrammetric system synchronized with two force plates, an eight-channel surface electromyographic system, recording the activity of four muscles bilaterally: Rectus femoris, tibialis anterior (TA), biceps femoris, and gastrocnemius lateralis (GL). The peak of the envelope (PoE) and its occurrence within the gait cycle (position of the peak of the envelope, PPoE) were calculated. Frequency-domain posturographic parameters were extracted while standing still on a force plate in eyes open and closed conditions for 60 s. After the treatment with Equistasi®, the mid-low (0.5–0.75) Hz and mid-high (0.75–1 Hz) components associated with the vestibular and somatosensory systems, PoE and PPoE, displayed a shift toward the values registered on the controls. Furthermore, a correlation was found between changes in proprioception (power spectrum frequencies during the Romberg Test) and the activity of GL, BF (PoE), and TA (PPoE). Results of this study could provide a quantitative estimation of the effects of a neurorehabilitation device on the peripheral and central nervous system in PD.

THREE DAYS MONITORING OF ACTIVITIES OF DAILY LIVING AMONG YOUNG HEALTHY ADULTS AND PARKINSON’S DISEASE PATIENTS

2021 ◽  
Vol 57 (2) ◽  
pp. 177-183
Author(s):  
Seong Hyun Moon ◽  
◽  
Rahul Soangra ◽  
Christopher F. Frames ◽  
Thurmon E. Lockhart ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Healthy Subjects ◽  
Neurodegenerative Disorder ◽  
Activity Level ◽  
Measurement Unit ◽  
Great Promise ◽  
Butterworth Filters

Parkinson’s Disease (PD) is a neurodegenerative disorder affecting the substantia nigra, which leads to more than half of PD patients are considered to be at high risk of falling. Recently, Inertial Measurement Unit (IMU) sensors have shown great promise in the classification of activities of daily living (ADL) such as walking, standing, sitting, and laying down, considered to be normal movement in daily life. Measuring physical activity level from longitudinal ADL monitoring among PD patients could provide insights into their fall mechanisms. In this study, six PD patients (mean age=74.3±6.5 years) and six young healthy subjects (mean age=19.7±2.7 years) were recruited. All the subjects were asked to wear the single accelerometer, DynaPort MM+ (Motion Monitor+, McRoberts BV, The Hague, Netherlands), with a sampling frequency of 100 Hz located at the L5-S1 spinal area for 3 days. Subjects maintained a log of activities they performed and only removed the sensor while showering or performing other aquatic activities. The resultant acceleration was filtered using high and low pass Butterworth filters to determine dynamic and stationary activities. As a result, it was found that healthy young subjects performed significantly more dynamic activities (13.2%) when compared to PD subjects (7%), in contrast, PD subjects (92.9%) had significantly more stationary activities than young healthy subjects (86.8%).

scholarly journals Cutaneous inputs from perineal region facilitates and modulates spinal locomotor activity and reduces cutaneous reflexes from the foot in spinal cats

2020 ◽  
Author(s):  
Angèle N Merlet ◽  
Jonathan Harnie ◽  
Madalina Macovei ◽  
Adam Doelman ◽  
Nathaly Gaudreault ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Nerve Stimulation ◽  
Rhythmic Activity ◽  
Short Latency ◽  
Cutaneous Reflexes ◽  
Excitatory Effect ◽  
Reflex Responses ◽  
Cutaneous Reflex ◽  
Weight Support ◽  
Perineal Region

AbstractIt is well known that mechanically stimulating the perineal region potently facilitates hindlimb locomotion and weight support in mammals with a spinal transection (spinal mammals). However, how perineal stimulation mediates this excitatory effect is poorly understood. We evaluated the effect of mechanically stimulating (vibration or pinch) the perineal region on ipsilateral (9-14 ms onset) and contralateral (14-18 ms onset) short-latency cutaneous reflex responses evoked by electrically stimulating the superficial peroneal or distal tibial nerve in seven adult spinal cats where hindlimb movement was restrained. Cutaneous reflexes were evoked before, during, and after mechanical stimulation of the perineal region. We found that vibration or pinch of the perineal region effectively triggered rhythmic activity, unilateral and bilateral to nerve stimulation. When electrically stimulating nerves, adding perineal stimulation modulated rhythmic activity by decreasing cycle and burst durations and by increasing the amplitude of flexors and extensors. Perineal stimulation also disrupted the timing of the ipsilateral rhythm, which had been entrained by nerve stimulation. Mechanically stimulating the perineal region decreased ipsilateral and contralateral short-latency reflex responses evoked by cutaneous inputs, a phenomenon we observed in muscles crossing different joints and located in different limbs. The results suggest that the excitatory effect of perineal stimulation on locomotion and weight support is not mediated by increasing cutaneous reflex gain and instead points to an excitation of central pattern-generating circuitry. Our results are consistent with a state-dependent modulation of reflexes by spinal interneuronal circuits.Significance StatementMechanically stimulating the skin of the perineal region strongly facilitates hindlimb locomotion in mammals following a complete spinal cord injury (SCI). Despite its remarkable effectiveness in promoting hindlimb locomotion in spinal cord-injured mammals, we do not know how this is mediated. The present study provides data on how inputs from the perineal region interact with neuronal circuits that generate locomotor-like activity and reflexes from the foot. A better understanding of how inputs from the perineal region interact with neuronal circuits of the spinal cord could lead to non-invasive approaches to restore walking in people with SCI.

Stroke Rehabilitation and Parkinson's Disease Tremor Reduction Using BCIs Combined With FES

2021 ◽  
pp. 473-491
Author(s):  
Sophie V. Adama ◽  
Martin Bogdan
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Healthy Subjects ◽  
Stroke Rehabilitation ◽  
Brain Computer Interface ◽  
Electrical Muscle Stimulation ◽  
Brain Signals ◽  
First Case ◽  
Bci System ◽  
Electrical Muscle

This article describes how Stroke and Parkinson's disease are two illnesses that particularly affect motor functions. With the advancements in technology, there is a lot of research focusing on finding solutions: to contribute to neuroplasticity in the first case, and to reduce symptoms in the second case. This manuscript describes the design of a brain-computer interface system (BCI) system paired with an electrical muscle stimulation suit for stroke rehabilitation and the reduction of tremors caused by Parkinson's disease. The idea is to strengthen the sensory-motor feedback loop, which will allow a more stabilized control of the affected extremities by taking into account the patient's motivation. To do so, his brain signals are measured to detect his intention to attempt to execute a movement, in contrast to the classical approach where the movement executions are imposed. A first feasibility study was completed. The author's next step is planning to test the system first with healthy subjects and finally with patients.

scholarly journals α-Synuclein oligomers in skin biopsy of idiopathic and monozygotic twin patients with Parkinson’s disease

Brain ◽  
2020 ◽  
Vol 143 (3) ◽  
pp. 920-931 ◽  
Author(s):  
Samanta Mazzetti ◽  
Milo J Basellini ◽  
Valentina Ferri ◽  
Erica Cassani ◽  
Emanuele Cereda ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Nervous System ◽  
Peripheral Nervous System ◽  
Genetic Predisposition ◽  
Healthy Subjects ◽  
Proximity Ligation Assay ◽  
Healthy Controls ◽  
Proximity Ligation ◽  
Synaptic Terminals

Abstract A variety of cellular processes, including vesicle clustering in the presynaptic compartment, are impaired in Parkinson’s disease and have been closely associated with α-synuclein oligomerization. Emerging evidence proves the existence of α-synuclein-related pathology in the peripheral nervous system, even though the presence of α-synuclein oligomers in situ in living patients remains poorly investigated. In this case-control study, we show previously undetected α-synuclein oligomers within synaptic terminals of autonomic fibres in skin biopsies by means of the proximity ligation assay and propose a procedure for their quantification (proximity ligation assay score). Our study revealed a significant increase in α-synuclein oligomers in consecutive patients with Parkinson’s disease compared to consecutive healthy controls (P < 0.001). Proximity ligation assay score (threshold value > 96 using receiver operating characteristic) was found to have good sensitivity, specificity and positive predictive value (82%, 86% and 89%, respectively). Furthermore, to disclose the role of putative genetic predisposition in Parkinson’s disease aetiology, we evaluated the differential accumulation of oligomers in a unique cohort of 19 monozygotic twins discordant for Parkinson’s disease. The significant difference between patients and healthy subjects was confirmed in twins. Intriguingly, although no difference in median values was detected between consecutive healthy controls and healthy twins, the prevalence of healthy subjects positive for proximity ligation assay score was significantly greater in twins than in the consecutive cohort (47% versus 14%, P = 0.019). This suggests that genetic predisposition is important, but not sufficient, in the aetiology of the disease and strengthens the contribution of environmental factors. In conclusion, our data provide evidence that α-synuclein oligomers accumulate within synaptic terminals of autonomic fibres of the skin in Parkinson’s disease for the first time. This finding endorses the hypothesis that α-synuclein oligomers could be used as a reliable diagnostic biomarker for Parkinson’s disease. It also offers novel insights into the physiological and pathological roles of α-synuclein in the peripheral nervous system.

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