Modulations of sensorimotor network through visual motor training in people with Parkinson's disease (PwPD)

Abstract

Community-based dance training has proven beneficial for people with Parkinson’s (PwPD) and their caregivers. It promotes structural and functional changes in brain regions associated with visual motor processes while improving quality of life, along with motor and non-motor symptoms. The specific neurobiological network effects of long-term dancing in a community setting are yet to be determined. This study seeks to elucidate specific contributions of visual motor learning on brain activation signal changes in areas associated with this network. This longitudinal neuroimaging investigation reports on neural changes for 10 PwPD who regularly participated in weekly Dance for Parkinson’s classes at Canada's National Ballet School for 8 months. Visual motor training included watching, following, and repeating complex motor sequences accompanied by live music provided in the studio. Participants progressed through upper and lower body sequences before engaging in whole-body movements through space in a learned choreographic sequence supported by in-class volunteers. Participants were instructed to imagine/visualise performing this choreography from a first-person perspective as if they were in the studio. Four scanning sessions were completed at different stages of learning in the months of September, December, January, and April while fMRI was performed while the participant listened to music and imagined the dance movements from the training classes for 1-minute blocks interspersed with 30s fixation blocks. Significant activations were observed in SMA, pre-SMA, auditory, insula, premotor, parietal, caudate, putamen, thalamus, cerebellum (P<0.0001, Bonferroni correction). The observed pattern of activation across timepoints demonstrates learning as an effect of long-term training in SMA, pre-SMA and cerebellum (P<0.05). These results indicate that long-term community dance training promotes BOLD cortical changes in regions involved in visual motor learning with imagery and performance. It is hypothesised that these functional changes are also associated with structural improvements that support adaptive plasticity.