Parkinson's Disease Clinical Trial
Official title:
The Role of Somatosensory Dysfunction as the Underlying Mechanism of Upper Limbs Motor Blocks in People With Parkinson's Disease With and Without Freezing of Gait
Motor blocks during gait and upper limb movements (FOULs) are a disabling and common motor
impairment in mild to severe stages of Parkinson's disease (PD). However, the main mechanism
underlying these phenomena is still an open debate. Apart from the motor correlates,
cognitive-attentional impairment and somatosensory deficits (especially in the proprioceptive
system) may underlie these motor blocks. The current study aims to unravel whether the
proprioceptive system is involved by manipulating task-relevant or non-relevant
proprioceptive stimuli.
Hence, the main aims of this study are:
(i) to assess the somatosensory function in people with PD that experience freezing of gait
FOG and (ii) to investigate the effects of manipulating both proprioception and attentional
resources on FOUL severity.
Forty-five people will be assigned to three age-matched groups (N=15 each): healthy elderly,
PD patients that experience FOG (FOG+) and PD patients that do not experience FOG. Cutaneous
sensory function and kinesthetic ability will be assessed by means of standardized
user-friendly methods and precise repositioning measures using the VICON motion analysis.
Additionally, participants will perform a newly developed task that can successfully elicit
FOULs (a handwriting freezing-provoking task) on a custom tablet (Heremans et al 2015). The
task will be performed without and with the use of muscle vibration (a well-known method to
stimulate the proprioceptive system). The investigators will manipulate both the timing of
vibration (relevant - after FOUL onset; or non-relevant: before FOUL onset) and the region of
stimulation (neutral: on a bone-mark where there is little if any proprioceptive stimulation;
and on a non-neutral spot: on the forearm muscles). It is believed that FOG+ will present
with worse somatosensory function than those who do not experience motor blocks (especially
in the proprioceptive system). Additionally, the Investigators expect a reduction in FOUL
severity (e.g. FOUL duration) when vibration is applied in a task-relevant way, independently
of the region stimulated. In contrast, it is also expected that when vibration is applied in
a non-relevant way and it may act as a distractor, FOUL duration will increase. This study
will thus be able to distinguish between the contribution of attentional and proprioceptive
resources to the mechanism of motor blocks in PD.
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