Dual Tasks in Parkinson’s Disease: Importance, Underlying Mechanisms and Treatment Approaches

Abstract

Parkinson's disease, which is caused by the degeneration of dopaminergic neurons, is one of the most common neurodegenerative diseases. Dopaminergic neurons are responsible for automating voluntary movement and behavioral processes, as well as motor behavior. Impairment in function of sensorimotor striatum affects negatively prior acquired automatic skills, new automatic skill acquisition and the ability to recovery lost automatic skills in individuals with Parkinson’s disease. As impaired motor automaticity will reflect on dual tasks, it is important to investigate dual tasks, that are ability of performing two tasks simultaneously. In addition to impaired motor automaticity, restricted attention resources and insufficient executive function may also lead to difficulty in dual tasks. Pharmacological approaches, transcranial direct current stimulation, and dual task training may be considered among the main approaches to improve this difficulty. In this review, movement automaticity, and neural mechanisms that provide automaticity have been described and movement automaticity in Parkinson’s disease, dual task difficulty, and approaches to reduce it have been explained.

Keywords

• Parkinson’s Disease
• Automaticity
• Dual Task

Project Number

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Parkinson Hastalığında İkili Görevler: Önemi, Altta Yatan Mekanizmaları ve Tedavi Yaklaşımları

Abstract

Dopaminerjik nöronların dejenerasyonuyla ortaya çıkan Parkinson hastalığı, en sık görülen nörodejeneratif hastalıklardan biridir. Dopaminerjik nöronlar, istemli hareket ve davranışsal süreçlerin yanı sıra motor davranışların otomatikleşmesinden de sorumludur. Sensorimotor striatum işlevinde bozulma Parkinson hastalığı olan bireylerde önceden edinilmiş otomatik becerileri, yeni otomatik beceri edinimini ve kaybedilen otomatik becerileri geri kazanma yeteneğini olumsuz etkilemektedir. Bozulan motor otomatiklik, aynı anda iki görevin gerçekleştirilebilme yeteneği olan ikili görevlere yansıyacağından ikili görevlerin incelenmesi önem taşımaktadır. Bozulan otomatikliğe ek olarak, sınırlı dikkat kaynakları ve yetersiz yürütme işlevi de ikili görevlerde zorluğa neden olabilmektedir. Farmakolojik yaklaşımlar, transkraniyal doğru akım stimülasyonu ve ikili görev eğitimi; bu zorluğu iyileştirmeye yönelik temel yaklaşımlar arasında sayılabilmektedir. Bu derlemede hareketlerin otomatikliği ve otomatikliği sağlayan nöral mekanizmaların tanımı yapılmış ve Parkinson hastalığında hareketlerin otomatikliği, ikili görev zorluğu ve onu azaltmaya yönelik yaklaşımlar açıklanmıştır.

Keywords

• Parkinson Hastalığı
• Otomatiklik
• İkili Görev

Supporting Institution

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Project Number

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Thanks

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