Rhythmic Auditory Stimulation on Neural Activity During Finger-tapping in PD Patients

Study Overview
=================
Brief Summary
-----------------
Introduction Bradykinesia (i.e., slow movements) is one of the most prominent symptoms of Parkinson's disease (PD) and has a negative impact on quality of life. Rhythmic auditory stimulation (RAS), a widely used and promising treatment technique, has been shown to effectively improve gait speed in PD patients. However, only few studies have explored effects and neural mechanisms of RAS on upper-limb movements. The investigators will conduct two studies to investigate effects and mechanisms of RAS on upper-limb movements in PD patients. The purpose of this study is to examine real-time neural activity when patients with PD and healthy controls listen to RAS and execute finger-tapping task simultaneously. Methods and analysis This study will recruit patients with PD and healthy controls. Electroencephalography (EEG) will be used under six conditions related to a finger-tapping task. Two-way repeated measures analysis of variance will be performed to investigate the group and condition effects on neural mechanisms. Study significance This study will offer evidence on RAS effects and mechanisms by investigating the changes in upper-limb movements and neural mechanisms during auditory-motor entrainment. Results from this study will provide a solid foundation for further research and clinical applications of RAS.

Official Title
-----------------
Effects and Neural Mechanisms of Rhythmic Auditory Stimulation on Upper-limb Movements in Patients With Parkinson's Disease

Conditions
-----------------
Acoustic Stimulation, Parkinson Disease, Electroencephalography

Intervention / Treatment
-----------------
* Behavioral: noF-noRAS
* Behavioral: F-noRAS
* Behavioral: noF-100RAS
* Behavioral: F-100RAS
* Behavioral: F-105RAS
* Behavioral: F-110RAS


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: (a) idiopathic PD diagnosed by a neurologist based on the Movement Disorders Society clinical diagnostic criteria; (b) the Hoehn and Yahr stage is 2 or 3, meaning that bilateral movement problems or combination with mild postural instability; (c) a score of Montreal Cognitive Assessment (MoCA) is equal to or higher than 21 to ensure that they understand experimental instructions; (d) a score of Edinburgh Handedness Inventory is above 60 to ensure that they are right-handed; (e) types and doses of medications remain unchanged in the past month right before participation. Age- and sex-matched healthy controls who filled the criteria (c) and (d) will be recruited from communities. Exclusion Criteria: the presence of medical conditions or diseases that may affect hand movements, vision, or hearing based on self-report.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| PD patients<br>Patients with Parkinson's disease | Behavioral: noF-noRAS<br>* resting state, that is, without finger-tapping and without listening to RAS<br>Behavioral: F-noRAS<br>* finger-tapping without listening to RAS<br>Behavioral: noF-100RAS<br>* listening to RAS with the 100% of the baseline tempo and without finger-tapping<br>Behavioral: F-100RAS<br>* finger-tapping and listening to RAS with 100 % of baseline tempo<br>Behavioral: F-105RAS<br>* finger-tapping and listening to RAS with 105 % of baseline tempo<br>Behavioral: F-110RAS<br>* finger-tapping and listening to RAS with 110 % of baseline tempo<br>|
| Healthy controls<br>Healthy older adults | Behavioral: noF-noRAS<br>* resting state, that is, without finger-tapping and without listening to RAS<br>Behavioral: F-noRAS<br>* finger-tapping without listening to RAS<br>Behavioral: noF-100RAS<br>* listening to RAS with the 100% of the baseline tempo and without finger-tapping<br>Behavioral: F-100RAS<br>* finger-tapping and listening to RAS with 100 % of baseline tempo<br>Behavioral: F-105RAS<br>* finger-tapping and listening to RAS with 105 % of baseline tempo<br>Behavioral: F-110RAS<br>* finger-tapping and listening to RAS with 110 % of baseline tempo<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The spectral power analysis of Electroencephalography (EEG) | The spectral power analysis (unit: watt) will be conducted | EEG will be continuously recorded during the whole experiment, which is about 20 minutes. | 
| The functional connectivity analysis of Electroencephalography (EEG) | The functional connectivity analysis (unit: coherence) will be conducted | EEG will be continuously recorded during the whole experiment, which is about 20 minutes. | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Acoustic Stimulation, Parkinson Disease, Movement, Electroencephalography