Objective: To compare neural activity differences between Parkinson’s disease patients responsive to rhythmic auditory stimulation (RAS-r) and those not responsive (RAS-n) using functional MRI (fMRI).

Background: RAS is emerging as a promising therapeutic and training modality for managing PD-related gait issues. However, individual variations can impact its effectiveness, necessitating an in-depth exploration of the underlying mechanisms.

Method: Twelve PD participants completed a 6-meter walking task under baseline and RAS conditions. A neurological music therapist provided brief tempo entrainment training before RAS-cued walking, set to each participant’s cadence. Gait parameters were assessed using inertial measurement unit (IMU) sensors. fMRI analyses included four conditions: {imaginary walking}, {RAS}, {imaginary walking + RAS}, and {resting state}, with independent component and task-based analyses performed. Independent component analysis (ICA) and task-based analyses were conducted using SPM12 and the CONN toolbox.

Results: Six participants were classified as RAS-r, showing increased cadence and velocity, while six were RAS-n, demonstrating decreased cadence and velocity. The characteristics and baseline gait were not different between groups [table1]. RAS-r exhibited trends toward increased swing phase and reduced stride time variability. In ICA,  RAS-n had decreased basal ganglion network (BGN) connectivity under RAS compared to resting state [figure1]. Task-based analysis revealed greater motor-related activation in RAS-r under {RAS} [figure2], with increased cerebellar and left angular gyrus activity in {imaginary walking + RAS} vs. {imaginary walking} conditions [figure3].

Conclusion: PD patients responsive to RAS demonstrated cerebellar and angular gyrus activation without BGN connectivity loss, leading to gait improvements. These findings support further investigation into personalized cueing strategies for optimizing RAS efficacy.

[table1]

[figure1]

[figure2]

[figure3]

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MDS Abstracts - https://www.mdsabstracts.org/abstract/neural-correlates-of-rhythmic-auditory-stimulation-responsiveness-in-parkinsons-disease-a-pilot-gait-and-fmri-study/