Objective: The aim of this study is to evaluate the priming effect of visual, auditory and cognitive tasks in enhancing Motor Imagery (MI) ability in subjects with Parkinson’s disease (PD) and Freezing of Gait (FOG).

Background: Motor Imagery is a self-generated, dynamic state during which the representation of a specific motor action is internally activated without any motor output. Evidence suggests that imagined and executed actions share the same neural structures recruiting overlapping brain regions¹.
Although PD affects movement speed during MI, authors suggest a substantially normal efficiency of MI in PD even if different patterns of cerebral activity were used². In contrast, results on PD with FOG are not conclusive. Indeed, a correct execution of MI requires executive resources³, like conscious elaboration and monitoring, that may be defective in PD with FoG⁴. Therefore, MI training in this population may be not effective in improving gait performance.

Method: 12 PD were asked to attend to four single sessions of MI training (one a week). Sessions consist of MI combined with motor execution or “boosted” MI training where participants were required to perform one of the “booster” tasks (1. attentional, 2. Action observation (AO), 3. Auditory observation) before MI and motor execution. The training was focused on 2 gait-related patterns (Gait Initiation and Turning). The order of each session was randomly assigned. Changes in motor performance was evaluated before and after each session by using inertial sensors. MI ability measures – MI questionnaire (GIQ), FOG severity (FOG-Q) – were taken at the end of the 4 training sessions.

Results: Overall, participants improved their motor imagery kinaesthetic capability (GIQ score; p<0.05) and reduced FOG symptoms (p<0.05). The results of Turning task showed a reduced duration (p<0.05), angle (p<0.05) and number of steps (p<0.05). The results of Gait Initiation task showed a reduced variability in first step length and APA execution (p<0.05). When differences among “booster” tasks were analysed, results showed that AO was superior in improving turning performance.

Conclusion: Our preliminary results show that to booster MI is feasible for enhancing MI ability and FoG. AO condition seems to better improve MI priming effect on motor performance.

References: 1.Decety, J., & Grèzes, J. (1999). Neural mechanisms subserving the perception of human actions. Trends in Cognitive Sciences, 3(5), 172–178.

2.Abbruzzese, G., Avanzino, L., Marchese, R., & Pelosin, E. (2015). Action Observation and Motor Imagery: Innovative Cognitive Tools in the Rehabilitation of Parkinson’s Disease. Parkinson’s Disease, 2015, 124214.

3.Glover, S., Bibby, E., & Tuomi, E. (2020). Executive functions in motor imagery: support for the motor-cognitive model over the functional equivalence model. Experimental Brain Research, 238(4), 931–944.

4.Heremans, E., Nieuwboer, A., Spildooren, J., Vandenbossche, J., Deroost, N., Soetens, E., et al. (2013). Cognitive aspects of freezing of gait in Parkinson’s disease: a challenge for rehabilitation. Journal of Neural Transmission (Vienna, Austria: 1996), 120(4), 543–557.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/boostering-motor-imagery-processing-to-improve-gait-in-patients-with-parkinson-disease-and-freezing-of-gait-a-preliminary-study/