Clinical trial NCT06918938: Visuomotor Control in Parkinson Disease
Official title: Unraveling Visuomotor Control in Parkinson Disease With and Without Freezing of Gait
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Parkinson Disease
Keywords: Parkinson disease
Transcranial magnetic stimulation
Motor control
Lead sponsor: National Taiwan University Hospital
Sponsor class: OTHER
First posted: 2025-04-09
Enrollment: 63
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: CROSS_SECTIONAL
Sampling method: PROBABILITY_SAMPLE
Study population: Participants with PD are idiopathic PD diagnosed by a neurologist, while healthy controls are absent of any neurological disorders.

Brief summary: Visuomotor processing is the ability to integrate visual information into motor plans and movement correction, which is highly required in daily activities such as writing and walking. As visual impairments have been reported in people with Parkinson's disease (PD), it is likely that those impairments may affect visuomotor processing ability and subsequently impair motor performance. Furthermore, people with PD and freezing of gait (FOG) have exhibited poorer visual perception than those without FOG, yet the differences of visuomotor control have not been well investigated. Additionally, little did the studies apply neurophysiological assessment to investigate the associated neural mechanisms. This study aims to investigate behavioral and neurophysiological differences in visuomotor control among people with PD and FOG (freezers), without FOG (non-freezers), and age-matched healthy controls. Sixty-three participants, 21 freezers, 21 non-freezers, and 21 age-matched healthy controls, will be enrolled in this study. Behavioral assessments, including a manual control task and visual perception tests will be used to evaluate visuomotor and visual perceptual abilities. Neurophysiological correlates, including corticomotor excitability and corticocortical connectivity between V1-M1 and PPC-M1, will be examined using transcranial magnetic stimulation. It is hypothesized that freezers will demonstrate the greatest visuomotor impairments and disrupted corticocortical connectivity compared to non-freezers and controls. By integrating behavioral and neurophysiological outcomes, this study seeks to unravel the mechanisms linking visual and motor impairments to FOG, ultimately providing insights into targeted interventions to improve visuomotor processing and motor performance in PD.


Eligibility criteria: Inclusion Criteria:

* age above 18
* able to follow the researchers' instructions
* normal or correct-to-normal vision to view a computer screen

Exclusion Criteria:

* neurological disorders other than PD
* diagnosed psychological disorders or a tendency of anxiety and/or depression
* a self-history of seizure or a family history of epilepsy
* deep brain stimulation or pacemaker implanted
* unstable cardiovascular diseases or other uncontrolled medical conditions
* pregnant
* surgical history, severe injury, or severe tremor of their upper extremities that can affect their movements in the past 6 months

Primary outcomes:
measure: Root-mean square-error
timeFrame: Day 1
measure: Directional error
timeFrame: Day 1
measure: Squared mean jerk
timeFrame: Day 1
measure: Movement time
timeFrame: Day 1
measure: Tracking interruption
timeFrame: Day 1
Secondary outcomes:
measure: Benton Judgment of Line Orientation Test
timeFrame: Day 1
measure: Random dot cinematogram
timeFrame: Day 1
measure: National Eye Institute Visual Function Questionnaire-25
timeFrame: Day 1
measure: Purdue Pegboard Test
timeFrame: Day 1
measure: Timed Up and Go Test
timeFrame: Day 1
measure: Movement Disorder Society Unified Parkinson's Disease Rating Scale
timeFrame: Day 1
measure: New Freezing of Gait Questionnaire
timeFrame: Day 1
measure: Cortical excitability
timeFrame: Day 1 and Day 2
measure: Corticocortical connectivity
timeFrame: Day 1 and Day 2
Other outcomes:
Locations:
Study officials:
affiliation: National Taiwan University
name: Graduate Institute of Physical Therapy
role: PRINCIPAL_INVESTIGATOR
References:
citation: Inzelberg R, Schechtman E, Hocherman S. Visuo-motor coordination deficits and motor impairments in Parkinson's disease. PLoS One. 2008;3(11):e3663. doi: 10.1371/journal.pone.0003663. Epub 2008 Nov 6.
citation: Palomar FJ, Conde V, Carrillo F, Fernandez-del-Olmo M, Koch G, Mir P. Parieto-motor functional connectivity is impaired in Parkinson's disease. Brain Stimul. 2013 Mar;6(2):147-54. doi: 10.1016/j.brs.2012.03.017. Epub 2012 Apr 15.