Abstract

Over the last two decades, experimental studies in humans and other vertebrates have increasingly used muscle synergy analysis as a computational tool to examine the physiological basis of motor control. The theoretical background of muscle synergies is based on the potential ability of the motor system to coordinate muscles groups as a single unit, thus reducing high-dimensional data to low-dimensional elements. Muscle synergy analysis may represent a new framework to examine the pathophysiological basis of specific motor symptoms in Parkinson’s disease (PD), including balance and gait disorders that are often unresponsive to treatment. The precise mechanisms contributing to these motor symptoms in PD remain largely unknown. A better understanding of the pathophysiology of balance and gait disorders in PD is necessary to develop new therapeutic strategies. This narrative review discusses muscle synergies in the evaluation of motor symptoms in PD. We first discuss the theoretical background and computational methods for muscle synergy extraction from physiological data. We then critically examine studies assessing muscle synergies in PD during different motor tasks including balance, gait and upper limb movements. Finally, we speculate about the prospects and challenges of muscle synergy analysis in order to promote future research protocols in PD.

Highlights

  • Parkinson’s disease (PD) globally affects 6.2 million people, representing the second most common neurodegenerative disorder after Alzheimer’s disease [1]

  • We critically examine previous studies addressing this topic in PD

  • Altered timing of modular activation may be responsible for abnormal motor control during gait in PD, rather than different muscle weighting vectors

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Summary

Introduction

Parkinson’s disease (PD) globally affects 6.2 million people, representing the second most common neurodegenerative disorder after Alzheimer’s disease [1]. L-dopa and other drugs acting on dopaminergic transmission are the most effective medical treatment for motor symptoms in PD patients [5,6]. Therapeutic management of the advanced disease stages is rather challenging due to complications related to the chronic intake of drugs, such as l-dopa-induced dyskinesia [5]. Clinical strategies to manage advanced disease stages include pharmacological treatments based on the continuous infusion of l-dopa/carbidopa intestinal gel or apomorphine, and non-pharmacological approaches based on deep brain stimulation (DBS) of the subthalamic nucleus and the globus pallidus pars interna [5,7]

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