Thalamic pathways mediating motor and non-motor symptoms in a Parkinson's disease model

Effects of different exercise types on balance function in healthy older adults and Parkinson's patients: a systematic review

Objective

This study aims to compare the effects of Tai Chi, yoga, and resistance training on balance function in healthy elderly individuals and patients with Parkinson's disease (PD). Given the well-documented benefits of these three exercise types in enhancing balance and motor function, it is crucial to assess their differential impacts.

Methods

A comprehensive search was conducted across PubMed, Web of Science, Scopus, and Cochrane Library databases through December 2023. Articles were selected based on predefined criteria, screened, and evaluated by two independent researchers who also extracted study characteristics. The risk of bias was assessed using the Cochrane risk of bias tool. The primary outcome measures were the Berg Balance Scale and the Timed Up and Go test, while the secondary measure was the Unified Parkinson's Disease Rating Scale Part III. A random effects model was employed, and heterogeneity was measured using the I 2 statistic.

Results

Of the 21 studies reviewed, 9 focused on healthy older adults and 12 targeted individuals with PD. The meta-analysis showed that Tai Chi, yoga, and resistance training significantly improved balance in patients with PD compared to control groups (p < 0.00001). Resistance training was most effective in enhancing dynamic balance in healthy older adults (p = 0.003), while Tai Chi had the most significant impact on balance improvement in PD patients (p < 0.00001). Notably, interventions conducted three to four times per week, each lasting 50-60 min and continued over 12 weeks, yielded the most substantial balance improvements.

Conclusion

Comparative analyses demonstrate that Tai Chi, yoga, and resistance training significantly enhance balance and motor function. Specifically, resistance training markedly improves dynamic balance in healthy elderly individuals, while Tai Chi shows pronounced improvements in motor function and balance for PD patients. Optimal balance improvements are achieved by performing interventions three to four times per week, with each session lasting 50-60 min, over 12 weeks.

Systematic review registration

https://inplasy.com/, identifier INPLASY202470042.

Progress of non‐motor symptoms in early‐onset Parkinson's disease

Parkinson's disease (PD) is a common degenerative disease of the central nervous system that is characterized by movement disorders and non‐motor symptoms (NMSs). The associated NMSs primarily include neuropsychiatric symptoms, autonomic dysfunction, sleep‐wake disorders, pain, fatigue, and hyposmia. These NMSs can occur at any stage of PD, especially before the onset of motor symptoms, and may affect a patient's quality of life more than motor symptoms. Although PD is most commonly diagnosed in people over 65 years, some patients exhibit symptom onset before the age of 50, which is clinically known as early‐onset Parkinson's disease (EOPD). The high heterogeneity and incidence of EOPD‐associated NMSs can lead to the misdiagnosis of EOPD as other neurodegenerative diseases. In this review, we discuss the research progress related to NMSs in patients with EOPD, focusing on neuropsychiatric disorders, autonomic dysfunction, sleep disorders, and sensory impairment, and outline the association of NMSs with different genotypic alterations, with the aim of providing assistance in the clinical management of patients.

Neural interfaces: Bridging the brain to the world beyond healthcare

Neural interfaces, emerging at the intersection of neurotechnology and urban planning, promise to transform how we interact with our surroundings and communicate. By recording and decoding neural signals, these interfaces facilitate direct connections between the brain and external devices, enabling seamless information exchange and shared experiences. Nevertheless, their development is challenged by complexities in materials science, electrochemistry, and algorithmic design. Electrophysiological crosstalk and the mismatch between electrode rigidity and tissue flexibility further complicate signal fidelity and biocompatibility. Recent closed-loop brain-computer interfaces, while promising for mood regulation and cognitive enhancement, are limited by decoding accuracy and the adaptability of user interfaces. This perspective outlines these challenges and discusses the progress in neural interfaces, contrasting non-invasive and invasive approaches, and explores the dynamics between stimulation and direct interfacing. Emphasis is placed on applications beyond healthcare, highlighting the need for implantable interfaces with high-resolution recording and stimulation capabilities.

Low and high-order topological disruption of functional networks in multiple system atrophy with freezing of gait: A resting-state study

OBJECTIVE

Freezing of gait (FOG), a specific survival-threatening gait impairment, needs to be urgently explored in patients with multiple system atrophy (MSA), which is characterized by rapid progression and death within 10 years of symptom onset. The objective of this study was to explore the topological organisation of both low- and high-order functional networks in patients with MAS and FOG.

METHOD

Low-order functional connectivity (LOFC) and high-order functional connectivity FC (HOFC) networks were calculated and further analysed using the graph theory approach in 24 patients with MSA without FOG, 20 patients with FOG, and 25 healthy controls. The relationship between brain activity and the severity of freezing symptoms was investigated in patients with FOG.

RESULTS

Regarding global topological properties, patients with FOG exhibited alterations in the whole-brain network, dorsal attention network (DAN), frontoparietal network (FPN), and default network (DMN), compared with patients without FOG. At the node level, patients with FOG showed decreased nodal centralities in sensorimotor network (SMN), DAN, ventral attention network (VAN), FPN, limbic regions, hippocampal network and basal ganglia network (BG), and increased nodal centralities in the FPN, DMN, visual network (VIN) and, cerebellar network. The nodal centralities of the right inferior frontal sulcus, left lateral amygdala and left nucleus accumbens (NAC) were negatively correlated with the FOG severity.

CONCLUSION

This study identified a disrupted topology of functional interactions at both low and high levels with extensive alterations in topological properties in MSA patients with FOG, especially those associated with damage to the FPN. These findings offer new insights into the dysfunctional mechanisms of complex networks and suggest potential neuroimaging biomarkers for FOG in patients with MSA.