Objective: To assess brain functional and structural changes following action observation training (AOT) associated with exercises of balance, gait, transfers and manual dexterity in Parkinson’s disease (PD) patients.

Background: Previous studies suggested the efficacy of AOT in reducing bradykinesia and improving autonomy in activity of daily living in PD patients.

Methods: Twelve PD patients were randomized into two groups: AOT-group and LANDSCAPE-group. In AOT-group, training consisted of AO combined with practicing the observed actions; LANDSCAPE-group performed the same exercises combined with landscape-videos observation. Both groups performed a 4-week training, three times a week, one hour each session. At baseline (T0) and week 4 (W4), patients underwent neurological, neuropsychological, and physiotherapy assessments. 3D T1-weighted, diffusion tensor (DT) MRI and functional MRI (fMRI) were acquired. FMRI tasks consisted of hand anti-phase movements and motor-imagery of circumstances representing activities of daily living. Clinical evaluations were repeated at 3-month follow-up.

Results: At W4, both groups showed changes of the step frequency during walking at spontaneous velocity. The AOT group had an improvement of quality of life (QoL) at W4 and velocity during manual activities at 3 months. During the hand anti-phase task, AOT-group showed an increased activity of frontal areas and a decreased recruitment of cerebello-thalamo-cortical  network, while the LANDSCAPE-group had an increased activity of the thalamus and a decreased recruitment of parietal areas. During the motor-imagery task AOT-group showed a reduced recruitment of the cerebello-thalamo-cortical  network and occipital areas, while the LANDSCAPE-group showed an increased activity of motor areas. Only in the AOT-group, functional plasticity was correlated with clinical changes such as improvements of QoL and velocity during manual activities. DT MRI analysis showed an increased white matter integrity of the cerebellar peduncles in the AOT-group which was correlated to functional changes in cerebellum.

Conclusions: AOT modulates both functional and structural brain plasticity. The combination between physical and cognitive exercises has the potential to stimulate motor learning and to provide a more long-lasting effect compared to a pure motor training in PD patients.

« Back to 2017 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/action-observation-training-effects-on-brain-structural-and-functional-changes-in-parkinsons-disease-patients/