The influence of posture duration on hand tremor during tasks with attention-distraction in persons with Parkinson’s disease

Malling, Anne Sofie Bøgh; Morberg, Bo Mohr; Wermuth, Lene; Gredal, Ole; Bech, Per; Jensen, Bente Rona

doi:10.1186/s12984-019-0534-8

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…Each session started with 15-min of introduction and sharing, followed by 60-min of guided mindfulness meditation (30-min was facilitated with the use of singing bowls) and mindful breathing techniques, and 15-min of closing and sharing. Owing to the physical symptoms of PD patients including tremor, rigidity and bradykinesia, prolonged holding of the same pose is not recommended 44 . Hence, verbal cues of gentle movements were incorporated every 10-min during the guided meditation practice, so as to avoid exacerbation of physical symptoms.…”

Section: Methodsmentioning

confidence: 99%

A randomized clinical trial of mindfulness meditation versus exercise in Parkinson’s disease during social unrest

Kwok

Choi

Wong³

et al. 2023

npj Parkinsons Dis.

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Clinical practice guidelines support resilience training and exercise for patients with Parkinson’s disease (PD). This assessor-blinded, randomized clinical trial aimed to compare the effects of a modified mindfulness meditation program versus stretching and resistance training exercise (SRTE) in patients with mild-to-moderate PD. A total of 126 potential participants were enrolled via convenience sampling, of which 68 eligible participants were randomized 1:1 to receive eight weekly 90-min sessions of mindfulness meditation or SRTE. Compared to the SRTE group, generalized estimating equation analyses revealed that the mindfulness group had significantly better improvement in outcomes, particularly for improving depressive symptoms (d, −1.66; 95% CI, −3.31 to −0.02) at week 8 and maintaining emotional non-reactivity at week 20 (d, 2.08; 95% CI, 0.59 to 3.56). Both groups demonstrated significant immediate, small-moderate effects on cognition (effect size [d] = 0.36–0.37, p = 0.006–0.011). Compared with the SRTE, mindfulness meditation appeared to be a feasible and promising strategy for managing depressive symptoms and maintaining emotional stability, with comparable benefits on cognitive performance. To combat the psychospiritual and cognitive sequelae of social unrest and COVID-19 pandemic, the integration of mindfulness training into motor-oriented PD rehabilitation protocols is recommended to strengthen the resilience and minimize the psycho-cognitive comorbidities among patients with mild-to-moderate PD.Trial Registration: HKU Clinical Trials Registry identifier: HKUCTR-2681.

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Section: Methodsmentioning

confidence: 99%

A randomized clinical trial of mindfulness meditation versus exercise in Parkinson’s disease during social unrest

Kwok

Choi

Wong³

et al. 2023

npj Parkinsons Dis.

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“…It is worth noting TSA-OFF tremor severity was markedly lower during in the 0-15s bin thus the lower extent of tremor reduction compared to other bins was likely because there were fewer tremors at baseline. Overall the severity of tremors we observed was varied in time which is a well-characterized feature of PD 32 . Some postural tremors are known to have a ∼ 10s latency (i.e., reemergence 33 ) which could explain the 0-15s bin data.…”

Section: Resultsmentioning

confidence: 80%

Algorithmic Virtual Reality Reduces Parkinsonian Tremor

Cornacchioli¹,

Galambos²,

Rentouli³

et al. 2023

Preprint

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Parkinson's disease (PD) is one of the most prevalent neurodegenerative disorders, affecting approximately 6-7 million patients worldwide. Involuntary hand tremor (IHT), one of the cardinal motor symptoms of PD, is extremely debilitating to patients reducing their quality of life. In this study, we combined neuroscience together with the nascent field of medical virtual reality (VR). Our goals were to 1) generate technology to enable PD patients to leapfrog the real life difficulties of living with IHT by entering VR metaverse worlds in which they are tremor-free and can function at new heights, 2) to determine whether lack of tremors in VR modifies central biofeedback mechanisms to non-invasively reduce tremors in real life. We thus generated algorithms that adjusted the moving average centroid of digital hands to stabilize tremors in VR. We implemented these algorithms in the Oculus Rift VR system and enrolled nine subjects with PD in a trial that yielded several important observations. First, we established the Oculus Rift as a potent measurement device for IHT. Secondly, we determined parkinsonian tremors can be abolished in VR with algorithms that removed up to 99% of tremors from PD subjects' digital hands (76% average reduction). These data suggest PD subjects can enter VR and be asymptomatic of PD IHT. To test whether our algorithms have measurable practical utility, we created a VR painting application, FingerPaint, and tested it against TiltBrush the leading VR painting application. We empirically demonstrate that complex freeform art created in FingerPaint had up to 51% reduction in tremor-associated parkinsonian drawing irregularities (24% average reduction). Lastly, we generated a technical framework wherein movements in the real-world can be measured side-by-side with those in VR. With this framework, we observed real life parkinsonian tremors were significantly reduced by up to 87% in real life when our algorithms abolished digital hand tremors in VR (35% average reduction). This reduction was observed in 78% of subjects and was progressive as subjects had increasingly reduced real life tremors the longer they were in VR.

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“…Leodori et al, 12 using corticomuscular coherence and transcranial magnetic stimulation (TMS), have shown a causal relationship between primary motor cortex (M1) activity and re‐emergent tremor. Malling et al 13 showed that tremor intensity increase is associated with an increasing or gradually more synchronized cortico‐spinal drive. Conversely, levodopa, which is known to decrease tremor intensity, is associated with inhibitory activity in the cerebellar nucleus of the thalamus 8 …”

mentioning

confidence: 99%

Persistence of Basal Ganglia Oscillatory Activity During Tremor Attenuation by Movement in Parkinson's Disease Patients

Wilken,

Andres,

Bianchi

et al. 2024

Movement Disorders

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BackgroundOne of the characteristics of parkinsonian tremor is that its amplitude decreases with movement. Current models suggest an interaction between basal ganglia (BG) and cerebello‐thalamo‐cortical circuits in parkinsonian tremor pathophysiology.ObjectiveWe aimed to correlate central oscillation in the BG with electromyographic activity during re‐emergent tremor in order to detect changes in BG oscillatory activity when tremor is attenuated by movement.MethodsWe performed a prospective, observational study on consecutive parkinsonian patients who underwent deep brain stimulation surgery and presented re‐emergent tremor. Coherence analysis between subthalamic nucleus/globus pallidus internus (STN/GPi) tremorous activity measured by microrecording (MER) and electromyogram (EMG) from flexor and extensor wrist muscles during rest, posture, and re‐emergent tremor pause was performed during surgery. The statistical significance level of the MER‐EMG coherence was determined using surrogate data analysis, and the directionality of information transfer between BG and muscle was performed using entropy transfer analysis.ResultsWe analyzed 148 MERs with tremor‐like activity from 6 patients which were evaluated against the simultaneous EMGs, resulting in 296 correlations. Of these, 26 presented a significant level of coherence at tremor frequency, throughout rest and posture, with a complete EMG stop in between. During the pause, all recordings showed sustained MER peaks at tremor frequency (±1.5 Hz). Information flows preferentially from BG to muscle during rest and posture, with a loss of directionality during the pause.ConclusionsOur results suggest that oscillatory activity in STN/GPi functionally linked to tremor sustains firing frequency during re‐emergent tremor pause, thus suggesting no direct role of the BG circuit on tremor attenuation due to voluntary movements. © 2024 International Parkinson and Movement Disorder Society.

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The influence of posture duration on hand tremor during tasks with attention-distraction in persons with Parkinson’s disease

Cited by 4 publications

References 22 publications

A randomized clinical trial of mindfulness meditation versus exercise in Parkinson’s disease during social unrest

A randomized clinical trial of mindfulness meditation versus exercise in Parkinson’s disease during social unrest

Algorithmic Virtual Reality Reduces Parkinsonian Tremor

Persistence of Basal Ganglia Oscillatory Activity During Tremor Attenuation by Movement in Parkinson's Disease Patients

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