Background. Nigrostriatal dopaminergic loss is a hallmark of Parkinson’s disease (PD) pathophysiology, leading to motor Parkinsonism. Different intervention protocols have shown that motor and cognitive functions improvement in PD occur via the modulation of distinct motor and cognitive pathways. Objective. To investigate the effects of two motor training programs on the brains’ functional networks in PD patients. Methods. Thirty-seven PD patients were prospectively studied. All enrolled patients underwent either treadmill training (TT) (n = 19) or treadmill with virtual reality (TT + VR) (n = 18) for 6 weeks. Magnetic resonance imaging (MRI) scans (3 T) acquiring 3-dimensional T1-weighted and resting-state functional MRI (rs-fMRI) data sets were performed at baseline and after 6 weeks. Independent component analysis (ICA) was conducted, and functional connectivity (FC) changes within large-scale functional brain networks were examined. Results. In both groups, significant post-training FC decrease in striatal, limbic, and parietal regions within the basal ganglia network, executive control network, and frontal-striatal network, and significant FC increase in the caudate, and cingulate within the sensorimotor network (SMN) were observed. Moreover, a significant time × group interaction was detected where TT + VR training had greater effects on FC levels in the supplementary motor area (SMA) and right precentral gyrus within the SMN, and in the right middle frontal gyrus (MFG) within the cerebellar network. These FC alterations were associated with improved usual and dual-task walking performance. Conclusions. These results suggest that TT with-and-without the addition of a VR component affects distinct neural pathways, highlighting the potential for beneficial neural plasticity in PD. Such distinctive task-specific pathways may foster the facilitation of interventions tailored to the individual needs of PD patients. Registered at Clinicaltrials.gov number: NCT01732653.

中文翻译：

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运动训练对帕金森病大脑静息状态功能网络的独特影响

背景。黑质纹状体多巴胺能丧失是帕金森病 (PD) 病理生理学的标志，导致运动性帕金森病。不同的干预方案表明，PD 中运动和认知功能的改善是通过调节不同的运动和认知途径来实现的。目标。研究两种运动训练计划对 PD 患者大脑功能网络的影响。方法。前瞻性研究了 37 名 PD 患者。所有登记的患者都接受了跑步机训练 (TT) (n = 19) 或虚拟现实跑步机 (TT + VR) (n = 18) 为期 6 周。在基线和 6 周后进行磁共振成像 (MRI) 扫描 (3 T) 获取 3 维 T1 加权和静息状态功能 MRI (rs-fMRI) 数据集。进行了独立成分分析（ICA），检查了大规模功能性大脑网络中的功能连接（FC）变化。结果。在这两个组中，基底神经节网络、执行控制网络和额叶纹状体网络内纹状体、边缘和顶叶区域的训练后 FC 显着减少，尾状核和感觉运动网络 (SMN) 内的扣带回的 FC 显着增加) 被观察到。此外，检测到显着的时间×组交互，其中 TT + VR 训练对辅助运动区 (SMA) 和 SMN 内的右中央前回以及小脑内的右额中回 (MFG) 的 FC 水平有更大影响网络。这些 FC 改变与改善通常和双任务步行性能有关。结论。这些结果表明，无论是否添加 VR 组件，TT 都会影响不同的神经通路，突出了 PD 中有益神经可塑性的潜力。这种独特的针对特定任务的途径可能会促进针对 PD 患者的个人需求量身定制的干预措施。在 Clinicaltrials.gov 注册编号：NCT01732653。