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NCT Number: NCT06918938

Visuomotor Control in Parkinson Disease

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.

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Key information

Conditions

Parkinson Disease Basal Ganglia Diseases Brain Diseases Central Nervous System Diseases Movement Disorders Nervous System Diseases Neurodegenerative Diseases Parkinsonian Disorders Synucleinopathies

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

School and Graduate Institute of Physical Therapy

Taipei, Zhongzheng Dist., 100, Taiwan

Location status: Recruiting

Location contact

Shwu-Fen Wang Director

CONTACT

[email protected]

886-2-33668156

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Primary outcomes

  1. Root-mean square-error

    Time frame: Day 1

    Overall performance accuracy relative to the target waveform, which is the mean difference between the target waveform and the participant's movement trajectory calculated over their actual movement time.

  2. Directional error

    Time frame: Day 1

    The value of the instantaneous component of the hand movement vector, perpendicular to the target trajectory in every sampled time point, which will be calculated and expressed as a percentage of the total movement vector

  3. Squared mean jerk

    Time frame: Day 1

    The squared mean of the jerk of the visuomotor trajectory, which a minor JSM is assumed a major smoothness by better controlling the movement.

  4. Movement time

    Time frame: Day 1

    Total movement time of a trial will be recorded.

  5. Tracking interruption

    Time frame: Day 1

    Frequency and duration of tracking interruptions will be recorded when the participant's cursor exits the target circle.

Secondary outcomes

  1. Benton Judgment of Line Orientation Test

    Time frame: Day 2

    A 30-item neuropsychological assessment of visuospatial ability. Participants are required to match 2 angled line portions on the top page to an array of 11 target lines, and the correction rate will be recorded.

  2. Random dot cinematogram

    Time frame: Day 2

    A psychological assessment of visual motor perception. Participants need to distinguish the coherent motion direction, and the correction rate and minimal detectable threshold of coherence will be recorded.

  3. National Eye Institute Visual Function Questionnaire-25

    Time frame: Day 2

    A 25-item self-reported questionnaire of visual-related activities, which the total score will be recorded.

  4. Purdue Pegboard Test

    Time frame: Day 2

    A behavioral assessment of hand dexterity ability. Participants are instructed to use one or both hands to sequentially move as many pegs into two parallel rows of holes as possible, within a set time limit, and the movement time will be recorded.

  5. Timed Up and Go Test

    Time frame: Day 2

    A behavioral assessment of dynamic balance ability. Participants will be instructed to rise from a chair, walk for 3 meters, turn around, return to the chair, and sit down, and the movement time will be recorded.

  6. Movement Disorder Society Unified Parkinson's Disease Rating Scale

    Time frame: Day 1

    A comprehensive scale of Parkinson disease characteristics, including non-motor aspects of experiences of daily living, motor aspects of experiences of daily living, motor examination, and motor complications. Scores of each subscales will be recorded.

  7. New Freezing of Gait Questionnaire

    Time frame: Day 1

    A self-reported questionnaire to evaluate the frequency and severity of freezing of gait in people with PD, which the total score will be recorded.

  8. Cortical excitability

    Time frame: Day 1 and Day 2

    Transcranial magnetic stimulation (TMS) device (The Magstim Company Ltd, Whitland, UK) will be used to determine the neurophysiology of corticomotor excitability.

  9. Corticocortical connectivity

    Time frame: Day 1 and Day 2

    Transcranial magnetic stimulation (TMS) device (The Magstim Company Ltd, Whitland, UK) will be used to determine the neurophysiology of corticocortical connectivity.

Study contacts

Contact information is provided by the study sponsor or research team.

Sung-Hao Lu

CONTACT

[email protected]

+886-9-79880052

Ya-Yun Lee, PhD

CONTACT

[email protected]

+886-2-33668155

Sponsors and collaborators

Lead sponsor

National Taiwan University Hospital

Other

Registry information

Official study title

Unraveling Visuomotor Control in Parkinson Disease With and Without Freezing of Gait

Important dates

Study start
2025
Primary completion
2028
Study completion
2028
First posted
Apr 9, 2025
Registry last updated
Aug 14, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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