Enhanced brain functional connectivity and activation after 12-week Tai Chi-based action observation training in patients with Parkinson's disease

Author: Lin Meng1, Deyu Wang1, Yu Shi1, Zhuo Li2, Jinghui Zhang2, Hanna Lu3, Xiaodong Zhu2, Dong Ming1,4
1 Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China.
2 Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.
3 Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
4 Department of Biomedical Engineering, School of Precision Instrument and Opto-Electronics Engineering, Tianjin University, Tianjin, China.
Conference/Journal: Front Aging Neurosci
Date published: 2023 Oct 10
Other: Volume ID: 15 , Pages: 1252610 , Special Notes: doi: 10.3389/fnagi.2023.1252610. , Word Count: 277

Motor-cognitive interactive interventions, such as action observation training (AOT), have shown great potential in restoring cognitive function and motor behaviors. It is expected that an advanced AOT incorporating specific Tai Chi movements with continuous and spiral characteristics can facilitate the shift from automatic to intentional actions and thus enhance motor control ability for early-stage PD. Nonetheless, the underlying neural mechanisms remain unclear. The study aimed to investigate changes in brain functional connectivity (FC) and clinical improvement after 12 weeks of Tai Chi-based action observation training (TC-AOT) compared to traditional physical therapy (TPT).

Thirty early-stage PD patients were recruited and randomly assigned to the TC-AOT group (N = 15) or TPT group (N = 15). All participants underwent resting-state functional magnetic resonance imaging (rs-fMRI) scans before and after 12 weeks of training and clinical assessments. The FCs were evaluated by seed-based correlation analysis based on the default mode network (DMN). The rehabilitation effects of the two training methods were compared while the correlations between significant FC changes and clinical improvement were investigated.

The results showed that the TC-AOT group exhibited significantly increased FCs between the dorsal medial prefrontal cortex and cerebellum crus I, between the posterior inferior parietal lobe and supramarginal gyrus, and between the temporal parietal junction and clusters of middle occipital gyrus and superior temporal. Moreover, these FC changes had a positive relationship with patients' improved motor and cognitive performance.

The finding supported that the TC-AOT promotes early-stage PD rehabilitation outcomes by promoting brain neuroplasticity where the FCs involved in the integration of sensorimotor processing and motor learning were strengthened.

Keywords: Parkinson’s disease; default mode network; motor-cognitive intervention; rehabilitation; restingstate functional MRI.

PMID: 37881362 PMCID: PMC10595151 DOI: 10.3389/fnagi.2023.1252610