Macerollo, Antonella; (2018) The role of somatosensory afferences in Parkinson's disease. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Parkinson’s disease (PD) is the second most common neurodegenerative disorder in the world. The primary motor symptom of PD is bradykinesia, a slowing and reduction in amplitude of voluntary movement. Here, I aim to test some neurophysiological aspects of PD. Furthermore, I explored the possibility to develop non-invasive treatment for this group of patients. The first two studies tested the contribution of a specific phenomenon labelled sensory attenuation or sensory gating in the motor symptoms of PD, especially bradykinesia. I found that the sensory attenuation is abnormal in this group of patients. Especially, PD patients OFF medications showed a reduced sensory attenuation measured as the amplitude of the somatosensory evoked potentials. Interestingly, I found that the sensory attenuation was equal to the healthy age matched controls when the patients were tested in ON pharmacological state. Additionally, this research tested a theory of the functional role of sensorimotor beta oscillations that could explain beta power modulations in healthy subjects and the increase in beta power observed in PD patients. My results were in line with the previous data presented in the literature. Indeed, I found the increase beta power in both my two cohorts of PD patients. Finally, I tested a potential correlation between the abnormalities of these two phenomena in PD: reduced sensory attenuation and increased beta oscillations. I did not find any significant correlation between the two phenomena. They might be two different neurophysiological mechanisms 5 underlying this disease. However, further studies are necessary to investigate this hypothesis. Having tested the influence of the somatosensory signal in some motor symptoms, the second part of the thesis was focused on the development of non-invasive treatments of bradykinesia in PD. I tested the impact of vibratory stimuli to improve these motor signs. In particular, several frequencies of vibration have been tested through different devices applied to the wrist. The device was called “Emma watch” and I found that the application of vibration with the modulation of 60 bpm improved the bradykinesia in PD patients Finally, I presented a case study regarding the benefit of vibratory stimulation on the freezing of gait thought shoe insoles generating vibration. The tested patient showed an improvement of the frequency of the freezing episodes after a week wearing the insoles, which generated vibration at 200 Hz.

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