Long-term impact of a community-based adapted boxing program on physical functioning and quality of life of individuals with Parkinson's disease.

BACKGROUND: Adapted boxing can help improve the physical functioning and health-related quality of life (HRQoL) of individuals with Parkinson's disease (PD). Whether these benefits persist longitudinally is unclear. OBJECTIVE: The purpose of this retrospective study was to evaluate the impact of a community-based adapted boxing program on the physical functioning and HRQoL of individuals with PD over 1-1.5 years. METHODS: Twenty-six individuals with PD agreed to share their results on tests administered upon enrollment in the program (PRE) and ∼431 days later (POST). The tests included the Fullerton Advanced Balance scale, (FAB), the Timed Up-and-Go test (TUG), the 30-second Sit-to-Stand test (30-STS), and the PD questionnaire-39 (PDQ-39). RESULTS: From PRE to POST, performance significantly improved on the TUG and 30-STS tests (both p < 0.001), but not on the FAB (p = 0.79). Over the same period, PDQ-39 scores significantly increased (p = 0.05). No PRE to POST changes surpassed the minimal detectable change threshold. CONCLUSION: The results of this study suggest that adapted boxing is at worst non-detrimental and at best potentially beneficial for muscle strength, endurance, and functional mobility in individuals with PD. However, adapted boxing probably cannot fully counteract the HRQoL decrements that accompany PD progression.

Magnetic Resonance Imaging and Nuclear Imaging of Parkinsonian Disorders: Where do we go from here?

Parkinsonian disorders are a heterogeneous group of incurable neurodegenerative diseases that significantly reduce quality of life and constitute a substantial economic burden. Nuclear imaging (NI) and magnetic resonance imaging (MRI) have played and continue to play a key role in research aimed at understanding and monitoring these disorders. MRI is cheaper, more accessible, nonirradiating, and better at measuring biological structures and hemodynamics than NI. NI, on the other hand, can track molecular processes, which may be crucial for the development of efficient diseasemodifying therapies. Given the strengths and weaknesses of NI and MRI, how can they best be applied to Parkinsonism research going forward? This review aims to examine the effectiveness of NI and MRI in three areas of Parkinsonism research (differential diagnosis, prodromal disease identification, and disease monitoring) to highlight where they can be most impactful. Based on the available literature, MRI can assist with differential diagnosis, prodromal disease identification, and disease monitoring as well as NI. However, more work is needed, to confirm the value of MRI for monitoring prodromal disease and predicting phenoconversion. Although NI can complement or be a substitute for MRI in all the areas covered in this review, we believe that its most meaningful impact will emerge once reliable Parkinsonian proteinopathy tracers become available. Future work in tracer development and high-field imaging will continue to influence the landscape for NI and MRI.

Single-Pulse TMS over the Parietal Cortex Does Not Impair Sensorimotor Perturbation-Induced Changes in Motor Commands.

Intermittent exposure to a sensorimotor perturbation, such as a visuomotor rotation, is known to cause a directional bias on the subsequent movement that opposes the previously experienced perturbation. To date, it is unclear whether the parietal cortex is causally involved in this postperturbation movement bias. In a recent electroencephalogram study, Savoie et al. (2018) observed increased parietal activity in response to an intermittent visuomotor perturbation, raising the possibility that the parietal cortex could subserve this change in motor behavior. The goal of the present study was to causally test this hypothesis. Human participants (N = 28) reached toward one of two visual targets located on either side of a fixation point, while being pseudorandomly submitted to a visuomotor rotation. On half of all rotation trials, single-pulse transcranial magnetic stimulation (TMS) was applied over the right (N = 14) or left (N = 14) parietal cortex 150 ms after visual feedback provision. To determine whether TMS influenced the postperturbation bias, reach direction was compared on trials that followed rotation with (RS + 1) and without (R + 1) TMS. It was hypothesized that interfering with parietal activity would reduce the movement bias following rotated trials. Results revealed a significant and robust postrotation directional bias compared with both rotation and null rotation trials. Contrary to our hypothesis, however, neither left nor right parietal stimulation significantly impacted the postrotation bias. These data suggest that the parietal areas targeted here may not be critical for perturbation-induced motor output changes to emerge.

Dissociation between Temporal and Spatial Anticipation in the Neural Dynamics of Goal-directed Movement Preparation.

It is well documented that providing advanced information regarding the spatial location of a target stimulus (i.e., spatial anticipation) or its timing of occurrence (i.e., temporal anticipation) influences reach preparation, reducing RTs. Yet, it remains unknown whether the RT gains attributable to temporal and spatial anticipation are subtended by similar preparatory dynamics. Here, this issue is addressed in humans by investigating EEG beta-band activity during reach preparation. Participants performed a reach RT task in which they initiated a movement as fast as possible toward visual targets following their appearance. Temporal anticipation was manipulated by having the target appear after a constant or variable delay period, whereas spatial anticipation was manipulated by precueing participants about the upcoming target location in advance or not. Results revealed that temporal and spatial anticipation both reduced reach RTs, with no interaction. Interestingly, temporal and spatial anticipation were associated with fundamentally different patterns of beta-band modulations. Temporal anticipation was associated with beta-band desynchronization over contralateral sensorimotor regions specifically around the expected moment of target onset, the magnitude of which was correlated with RT modulations across participants. In contrast, spatial anticipation did not influence sensorimotor activity but rather led to increased beta-band power over bilateral parieto-occipital regions during the entire delay period. These results argue for distinct states of preparation incurred by temporal and spatial anticipation. In particular, sensorimotor beta-band desynchronization may reflect the timely disinhibition of movement-related neuronal ensembles at the expected time of movement initiation, without reflecting its spatial parameters per se.

Luring the Motor System: Impact of Performance-Contingent Incentives on Pre-Movement Beta-Band Activity and Motor Performance.

It has been shown that when incentives are provided during movement preparation, activity in parieto-frontal regions reflects both expected value and motivational salience. Yet behavioral work suggests that the processing of rewards is faster than for punishments, raising the possibility that expected value and motivational salience manifest at different latencies during movement planning. Given the role of beta oscillations (13-30 Hz) in movement preparation and in communication within the reward circuit, this study investigated how beta activity is modulated by positive and negative monetary incentives during reach planning, and in particular whether it reflects expected value and motivational salience at different latencies. Electroencephalography was recorded while male and female humans performed a reaching task in which reward or punishment delivery depended on movement accuracy. Before a preparatory delay period, participants were informed of the consequences of hitting or missing the target, according to four experimental conditions: Neutral (hit/miss:+0/-0¢), Reward (hit/miss:+5/-0¢), Punish (hit/miss:+0/-5¢) and Mixed (hit/miss:+5/-5¢). Results revealed that beta power over parieto-frontal regions was strongly modulated by incentives during the delay period, with power positively correlating with movement times. Interestingly, beta power was selectively sensitive to potential rewards early in the delay period, after which it came to reflect motivational salience as movement onset neared. These results demonstrate that beta activity reflects expected value and motivational salience on different time scales during reach planning. They also provide support for models that link beta activity with basal ganglia and dopamine for the allocation of neural resources according to behavioral salience.SIGNIFICANCE STATEMENT The present work demonstrates that pre-movement parieto-frontal beta power is modulated by monetary incentives in a goal-directed reaching task. Specifically, beta power transiently scaled with the availability of rewards early in movement planning, before reflecting motivational salience as movement onset neared. Moreover, pre-movement beta activity correlated with the vigor of the upcoming movement. These findings suggest that beta oscillations reflect neural processes that mediate the invigorating effect of incentives on motor performance, possibly through dopamine-mediated interactions with the basal ganglia.

Added value of money on motor performance feedback: Increased left central beta-band power for rewards and fronto-central theta-band power for punishments.

Monetary rewards and punishments have been shown to respectively enhance retention of motor memories and short-term motor performance, but their underlying neural bases in the context of motor control tasks remain unclear. Using electroencephalography (EEG), the present study tested the hypothesis that monetary rewards and punishments are respectively reflected in post-feedback beta-band (20-30 Hz) and theta-band (3-8 Hz) oscillatory power. While participants performed upper limb reaching movements toward visual targets using their right hand, the delivery of monetary rewards and punishments was manipulated as well as their probability (i.e., by changing target size). Compared to unrewarded and unpunished trials, monetary rewards and the successful avoidance of punishments both entailed greater beta-band power at left central electrodes overlaying contralateral motor areas. In contrast, monetary punishments and reward omissions both entailed increased theta-band power at fronto-central scalp sites. Additional analyses revealed that beta-band power was further increased when rewards were lowly probable. In light of previous work demonstrating similar beta-band modulations in basal ganglia during reward processing, the present results may reflect functional communication of reward-related information between the basal ganglia and motor cortical regions. In turn, the increase in fronto-central theta-band power after monetary punishments may reflect an emphasized cognitive need for behavioral adjustments. Globally, the present work identifies possible neural substrates for the growing behavioral evidence showing beneficial effects of monetary feedback on motor learning and performance.

Effect of Hypohydration on Muscle Endurance, Strength, Anaerobic Power and Capacity and Vertical Jumping Ability: A Meta-Analysis.

BACKGROUND: How hypohydration impacts non-bodyweight (BW)-dependent muscle performance and vertical jumping ability remains to be determined using meta-analytic procedures. OBJECTIVES: Our objective was to determine the impact of hypohydration on muscle endurance, strength, anaerobic power and capacity and vertical jumping ability using a meta-analytic approach. DATA SOURCES: Studies were located using database searches and cross-referencing. SYNTHESIS METHODS: Effect summaries were obtained using random-effects models; method of moments mixed-effects analysis-of-variance-like procedures were used to determine differences between groups; and restricted maximum likelihood random-effects meta-regressions were performed to determine relationships between variables, impact of confounders, and interaction effects. RESULTS: A total of 28 manuscripts met the inclusion criteria, producing six (upper body muscle endurance), ten (lower body muscle endurance), 14 (upper body muscle strength), 25 (lower body muscle strength), nine (muscle anaerobic power), nine (muscle anaerobic capacity), and 12 (vertical jumping ability) effect estimates. Hypohydration impaired overall muscle endurance by 8.3 ± 2.3% (P < 0.05), with no significant difference between upper body (-8.4 ± 3.3%) and lower body (-8.2 ± 3.2%). As a whole, muscle strength fell by 5.5 ± 1.0% (P < 0.05) with hypohydration; the difference between lower (-3.7 ± 1.8%) and upper (-6.2 ± 1.1%) body was non-significant. Anaerobic power (-5.8 ± 2.3%) was significantly altered with hypohydration, but anaerobic capacity (-3.5 ± 2.3%) and vertical jumping ability (0.9 ± 0.7%) were not. No significant correlations were observed between the changes in any of the muscle performance variables or vertical jumping ability and the changes in hypohydration level. Using an active procedure to dehydrate participants decreased muscle performance by an additional 5.4 ± 1.9% (2.76-fold) (P = 0.02) compared with using a passive dehydration procedure. Trained individuals demonstrated a 3.3 ± 1.7% (1.76-fold) (P = 0.06) lesser decrease in muscle performance with hypohydration than did untrained individuals. CONCLUSION: Hypohydration, or factors associated with dehydration, are likely to be associated with practically important decrements in muscle endurance, strength, and anaerobic power and capacity. However, their impact on non-BW-dependent muscle performance is substantially mitigated in trained individuals or when hypohydration is induced passively. Conversely, it is possible that body water loss (~3% BW) may improve performance in BW-dependent tasks such as vertical jumping ability.