Abstract
Training based on rhythmic auditory stimulation (RAS) can improve gait in patients with idiopathic Parkinson’s disease (IPD). Patients typically walk faster and exhibit greater stride length after RAS. However, this effect is highly variable among patients, with some exhibiting little or no response to the intervention. These individual differences may depend on patients’ ability to synchronize their movements to a beat. To test this possibility, 14 IPD patients were submitted to RAS for four weeks, in which they walked to music with an embedded metronome. Before and after the training, patients’ synchronization was assessed with auditory paced hand tapping and walking to auditory cues. Patients increased gait speed and stride length in non-cued gait after training. However, individual differences were apparent as some patients showed a positive response to RAS and others, either no response, or a negative response. A positive response to RAS was predicted by the synchronization performance in hand tapping and gait tasks. More severe gait impairment, low synchronization variability, and a prompt response to a stimulation change foster a positive response to RAS training. Thus, sensorimotor timing skills underpinning the synchronization of steps to an auditory cue may allow predicting the success of RAS in IPD.
Highlights
This network may support compensation of motor behavior in idiopathic Parkinson’s disease (IPD) patients via auditory cueing. This possibility is supported by the results of a PET study showing increased cerebellar activation after a cueing-based training programme[36]. The importance of such general timing skills is consistent with recent evidence that the benefits of musically-cued gait training, a program based on RAS, extend beyond gait, and positively impact general perceptual and sensorimotor timing processes[37]
The participants were trained using a program based on RAS, namely a musically-cued gait training (MCGT; see Benoit et al.)[37]
The goal of the present study was to examine the role of sensorimotor timing skills, tested with gait and tapping tasks, to evaluate the efficacy of RAS in persons with IPD
Summary
We examined the role of sensorimotor timing skills, measured with hand tapping and in gait as prime factors affecting patients’ response to RAS. To this end, IPD patients were submitted to a 1-month gait-training program using RAS with musical stimuli, and tested immediately after the training, and one month post-training. Patients’ ability to synchronize movements (steps and hand taps) to sounds was assessed before and after the gait training, and the results were used to test whether sensorimotor timing skills were linked to the benefits of RAS on gait kinematics. Variables reflecting sensorimotor timing skills, such as synchronization accuracy and variability, or the flexibility of the motor response to a stimulus change were expected to predict whether a patient responded positively or not to the training
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