To investigate the differential effects of two motor training programs on the brains' functional networks in Parkinson's disease (PD) patients.

37 PD patients (mean age= 72 ± 6.5 yrs) were prospectively studied. PD patients underwent either treadmill (TT) (n= 19) or treadmill with virtual reality (TT+VR) (n =18) training for 6 weeks. All participants underwent 3 T MRI scan acquiring 3D T1-Weighted and resting-state r-fMRI datasets at baseline and after 6-weeks. Independent component analysis (ICA) was conducted for rs-fMRI datasets, and functional connectivity (FC) changes over time were examined within large-scale functional brain networks. A significance level of p< 0.01, FWEcwas adopted for all comparisons.

Post-training, the TT+VR group demonstrated significant FC increase in the right superior gyrus within the ECN, in the right inferior frontal gyrus (R IFG), right precentral gyrus, and right middle occipital gyrus within the salience network. ΔFC in R IFG correlated significantly with the overtime change in DT stride length (r=-0.64, p=0.033). In the TT group, post-training FC increase was observed in the bilateral superior frontal gyrus (SFG) within the ECN, in the right angular gyrus, and the left middle cingulate cortex (L MCC) within the SMN. ΔFC in the MCC correlated significantly with Δ change in usual walk (UW) gait speed (r=0.57, p=0.02, and r=0.64, p=0.007 respectively). 

The present results suggest that treadmill training with and without the addition of a VR component affects multiple neural pathways, highlighting the potential for beneficial neural plasticity in PD. Such distinctive task-specific pathways may foster the facilitation of novel interventions tailored to the individual needs of these patients.