To obtain more fundamental insight in the disrupted sensorimotor integration in patients with Parkinson*s disease, especially with regard to the impact of visual stimuli on the cerebral systems involved in walking. This knowledge provides a basis…
ID
Source
Brief title
Condition
- Movement disorders (incl parkinsonism)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The study parameter is the cerebral activation determined with the used of
fMRI.
Secondary outcome
n.a.
Background summary
Walking in patients with Parkinson*s disease is influenced by visual stimuli,
both supporting as well as inhibitory. Previous research by patients with
Parkinson*s disease showed that walking was easier during wide field expanding
optic flow than during small field optic flow [Van der Hoorn et al., in prep].
The difference during wide and small field represents the situation during
freezing of gait (FOG) when approaching a narrow passage [Giladi et al., 1992].
A fMRI research in healthy volunteers showed that wide field optic flow
activates the right dorsal premotor cortex. This premotor activation
disappeared when narrowing the flow field. At the moment mediofrontal
activation appeared [Van der Hoorn et al., subm.]. This showed a shift from
external motor support to an internal motor generation. We aspect that this
shift by patients with Parkinson*s disease is disrupted due to a inadequate
output from the basal ganglia to the mediofrontal cortex.
In the present study we aim to investigate the cerebral activation patterns due
to optic flow and modulation of optic flow in patients with Parkinson*s disease
with and without FOG in comparison with healthy controls of comparable age.
During wide field forward optic flow, dots appear form the centre of the
horizon and expand with increasing speed radial to the lower part of the
monitor (De Jong et al., 1994).
Study objective
To obtain more fundamental insight in the disrupted sensorimotor integration in
patients with Parkinson*s disease, especially with regard to the impact of
visual stimuli on the cerebral systems involved in walking. This knowledge
provides a basis for more targeted patients* selection for specific treatment
strategies.
Study design
This study concerns a fMRI-activation study, in which subject are watching a
monitor while lying in the MRI. Three experimental conditions are displayed in
a pseudo-randomized order. In condition 1 wide field forward optic flow is
followed by a narrowing of the optic flow field, after which narrow field optic
flow is shown (forward flow wide - narrow). In condition 2 (forward flow wide -
stationary) the wide field optic flow is followed by stationary wide field of
dots. In condition 3 (stationary wide - narrow) a stationary wide field of dots
in the lower half of the monitor is followed by a narrowing resulting in a
narrow field stationary dots.
Study burden and risks
The use of MRI is very safe when paying close attention to contra indications
for a MRI scan. The contra indications will be inventoried during the
telephonically contact for making a appointment. This issue is addressed
explicitly in the informed consents forms and will be controlled before the MRI
scan is actual performed.
Hanzeplein 1
Postbus 30.001, 9700 RB Groningen
NL
Hanzeplein 1
Postbus 30.001, 9700 RB Groningen
NL
Listed location countries
Age
Inclusion criteria
Patients with Pakinsons disease (15 with and 15 without FOG) as well as healthy controls with comparable age and sex will by selected. (protocol 4.2 Inclusion criteria p. 13)
Exclusion criteria
Patients with a tremor of the head to such an extend that lying still during the scan is not possible, will be excluded. Subjects with neurological or uncorrected ophthalmological disorders will be excluded as well as subjects who fulfill one of the exclusion criteria for conducting a MRI. An age limit of 84 is used.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL32970.042.10 |