I’m starting a new thread about ‘banding’ to discuss WHY we think it works. I think it should be separate from a thread about IF it works for us. Plus, I’m so excited about my theory that I think it deserves its own thread.

My theory is surprisingly simply, but makes so much sense to me, and jives with my personal experiences using external cues and prompts with much success the last couple of years.

My theory has to do with closed loop control vs open loop control. It’s easy; let me explain. An open loop control does NOT use feedback; a closed loop control uses feedback.

My open loop control doesn’t work properly. Open loop control should work automatically. Mine doesn’t all the time, which is probably why, for example, why my right arm doesn’t swing when I walk. In normal people it swings automatically, without any kind of feedback.

I believe that external cues and sensory feedback work by switching our brains to conscious closed loop control, instead of our defective automatic control.

It utilizes feedback, such as visual cues, auditory cues, and sensory feedback, such as the bands. It works instantaneously like a switch, setting up a different kind of control over our movements.

It enables us to immediately access closed loop control, and we start feeling more normal because we have a new kind of control system activated by the feedback, instead of the open loop control normal people use automatically.

That’s why outer directed movement is easier for me than inner directed movements. Outer directed movements utilize external feedback.

This theory jives with my personal experiences with external cues and prompts. Often, when I don’t have an external prompt, I imagine one, and it works for me. Some examples of external prompts:

1. When I put my legs out, while sitting, my right foot turns inward. I’m unable to straighten it. BUT, if I imagine that I’m pushing my foot against someone’s hand, I’m able to move my foot and straighten it.

2. If I feel stuck in a sitting position, I imagine that I’m reaching for something that someone is handing me, and I’m able to get up instantly.

3. If I have trouble making a 90 degree turn, I imagine that I’m pushing something ahead of me and I turn easier.

4. When I have trouble walking, getting my right leg to move, I imagine that I’m kicking something with my right foot, and I can move much more easily.

These are external prompts which result in outer directed movement. I think they work by enabling closed loop control, which I need to use because my open loop control is disabled.

I use external visual and auditory cues to aid movement. I rely heavily on visual cues when walking. Lines on a sidewalk are best. I focus on a line several steps ahead of me and as I approach the line, my eye darts to the next line and I move towards that on. When there are no lines, I use a leaf, or a different colored brick, or I try to imagine a line. When walking along in bright light, I immediately slow down when it becomes dark because my visual cue is missing.

When visual cues aren’t easily seen, I rely on my inner metronome. I count 1…2…1…2…, with a number on each right step, and it helps me enormously. Singing outloud is also a big help.

The banding is a different kind of external feedback, one that was new to me. The scarf that works for me gives me a kind of sensation that produces sensory feedback.

It works instantly for me and I think it enables immediate closed loop control. When the scarf is wrapped around my head, my whole face perks up, and my speech is much better which is amazing to me. I clearly have better control over my speech, and I think it’s because I’m using closed loop control vs defective automatic open loop control. It’s the sensory feedback that turns that control on.

SO, do my external prompts work in the same way as external cues? I think they both provide needed feedback. The feedback enables closed loop control and works instantly, just like we saw with the banding.

I think that when Anne was in her deep OFF at the hospital, her automatic control was disabled. The banding probably worked because it immediately set up a closed loop control of her body. It required feedback; in this case, sensory feedback from the bands.

Like in Awakenings, when seemingly catatonic people were able to catch a ball that was thrown to them; an external prompt that immediately worked.

Rick was able to stand longer when banded. I read that when standing, postural control uses an open loop control in the short term, and closed loop over a long term. Perhaps, Rick needed an external cue, external feedback from the bands, to enable his closed loop control, which resulted in being able to stand for hours.

It’s possible that the lack of dopamine leads to ineffectual automatic open loop control. We can bypass this dysfunction by enabling conscious closed loop control using external feedback via cues or prompts or sensory feedback, like the bands.

Does this make sense to you, too?

Thanks for reading!

~Zucchini

....(you don't mind if I call you "Zflwr" do you? I know we hardly know one another and all.... )

Sorry, couldn't help myself. But seriously, it is a good theory and may well be right. Or it may be part of a bigger one. Some questions that we have to answer sooner or later:

Why does wrapping an arm for example affect another part such as the face? Does this require a central point in the brain where the loops for those parts converge? Or is one loop causing a change in function that benefits the others?

Is the same effect behind what I call the staircase phenomenon- the fact that so many of us barely crawl yet we get to a stairway and we can dance up and down as we please?

How do we optimize the effect? When is it best to apply the wraps? How long? How often?

There's a lot of research to be done. Maybe we can raise enough dust that MJFox or similar will shift a little funding in that direction. Heck, anybody can look at a rat slice on a slide, but it takes real courage to wander the City looking like an escaped mummy.

Hi guys

I am with you! Interresting, ZucchiniFlower! And, Rick, I also like the thread you posted on therapies to come.

To me, it makes sense! I couldn't express it better than Rick saying it might be something or part of a bigger theory. Oh Anne, come on, you're needed! lol

Greetings
Karine

It's not the theory of everything, guys, just a tease, an aspect of what I think is happening. The details elude me! Great questions, Rick.

It may have to do with the pre-motor areas of the brain, like the SMA (supplementary motor area). In PD, those areas are underactivated and underreactive. It's possible that external cues activate those areas, which is why wrapping my head helps me speak better.

Climbing stairs may involve external cues; like the lines in the sidewalk, we have lines of steps.

The bands do not help my start hesitiation at the bottom or top of stairs, or getting off the train. I get stuck in place because my my premotor organization is off kilter, I believe. My inner metronome does help me with that. Maybe it helps me organize my movements by activating that part of the brain involved in preplanning.

I love imagining us as navigating around wrapped up like mummies. Very funny, Rick.

An example of conscious movement that works vs unconsious automatic movement that is disabled:

Parkinson's Sufferers Get Their Groove Back Through Dance

http://70.47.124.114/node/226

I remember a poster on BT1 discussing wearing a fishing hat with small weights sewn into the band in unequal measures--will attempt to unearth the postings--but sounds as if the same physiological responses are operating as in banding....madelyn

Madelyn, I looked for that post, too, and wasn't able to find it. I hope you do.

In rethinking about the staircase effect, I realized that I have an easier time walking up an incline than on a flat surface. There must be something about the stairs or a hill that triggers something in us and allows us to climb with ease.

Hi Z.Flower,

I like the way you think and i do believe that what's on is something close to your explanations.

Let's make some hypotheses I will put in "easy words" so that everybody could understand.
When we move, the motor command works on our muscles and their variation in length and tension puts limbs (or head or body) in a certain position, with a certain speed and a certain muscular tension.
All our proprioceptors, these receptors located in deep under skin, or in joints and in muscles, give back informations to our brain i this way:
"Hep you, yes, youuuuu! Brainie! Give a little bit more command to the right;..oooooop's, not that much….yes , now, up…turned a millimeter more…OK…here you are…stop it…..great, good boy, Brainie"

Question: what happens to Brainie when the sensitive stimuli are either really weird or absolutly silent?
"µ&♪░Фў"…………"Sorry, are you talking to me?" asks Brainie?
And what happens when little Brainie wonders??? He may well stop command because he does not know if its orders are even listened at.

So the first hypothesis may be:
"Brain motor command cannot work normally without normal sensory feedback" which is definitely sure and leads to….hypertonia and bradykinesia.

Second question is about these sensory stimuli.
Are they wrong from the beginning (wrong reception of sensory stimuli), and/or wrongly transmitted and/or understood by brain and/or integrated in the sensorimotor loops?
This I just can't know exactly but, in fact, it doesn't change much as far as we know that the loop is working wrong.

In my opinion (or imaginings) I suppose there is a kind of very quick butterfly effect with disruption of normal regulation of the loop starting because of motor command regulation impairement with lack of DA in SN, then sensory feedback giving a weird signal and again till triggering of hypertonia and akinesia.

Hope you can follow my thoughts....

Anne

Hi Anne,

I like the way you think, too!

I think I’m following what you’re saying. I, too, believe proprioception is a big part of this conundrum.

A couple of years ago, there were times when walking on a flat surface, it felt like I was walking up and down hills. And when I stood, it felt like I was standing on the side of a hill. It was so bizarre and awful. I think my proprioceptors were out lunch those hours.

I think there’s more than disruption of proper sensory feedback at play. I’ve read that speech problems are not related to the dopaminergic system. But, I believe that mine may be. I think it has to do with overactivation of some of the muscles in my jaw, my tongue. I can’t say “buy bobby a puppy” without my mouth going into contortions. Something is overstimulating certain muscles, I think.

My speech gets worse as the day goes on, and I believe the less dopamine I have available, late in the day, does affect the way I speak. I do think the bands stimulate a part of my brain that gets that hypertonia under control so I can speak much better.

With the band on my leg, my balance seems improved. I’ve read that postural problems are not related to the dopaminergic system. Is the banding effect the same in theory for rigidity, akinesia, dystonia, speech, balance?

The banding may work in a few different ways; or there may be one overall effect that improves all of these symptoms.

I think it may be in the area of the brain that involves preplanning. I find that if I repeat “buy bobby a puppy” over and over in my head, i.e. consciously planning, I’m able to say it! But just once. I can’t say it twice. I need to preplan again.

To overcome difficulty initiating movement, when I stand up to walk, I imagine myself walking and I count in my head, and it helps me get going. I need to preplan my action consciously.

I think the sensory feedback from the bands stimulates an underactive part of the brain and activates a different motor pathway than we were using, which activates our muscles to work properly. Thus, dystonia, rigidity, akinesia have a foe to deal with now because the biofeedback bands awoke and rallied some of our troops!

It's possible that defective proprioceptive feedback inhibits closed loop control of our movements. We need closed loop control to work because the open loop control isn't working right either. The biofeedback from the bands may allow us to use closed loop control, which requires feedback, and our muscles start to work correctly.

Again, the example of Rick being about to stand for a long time with the bands: closed loop control is required when standing for a long time (from research I read). 'Normally', Rick could not stand for a long time, probably because his closed loop control was not working correctly, possibly because his proprioceptive feedback was confused. With the banding, proper feedback was restored, and the closed loop control of his muscles could take effect. Thus, he can stand for hours with the banding.

~Zuccchini

ZF

Here's an interesting study. Stuttering seems so much like Parkinson's but I read somewhere that it is the opposite [too much dopamine]. My speech races when I am off. I think speech might be more involved than you think. Anyway just FYI:

http://www.clinicaltrials.gov/ct/show/NCT00024960

paula

Paula, you posted while I was editing and making more sense out of my last post, so please read it again.

Thanks for the heads up about stuttering. This looks interesting, too:

J Commun Disord. 2004 Jul-Aug;37(4):325-69.
Stuttering and the basal ganglia circuits: a critical review of possible relations.

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Citation

full article:

http://www.sciencedirect.com/science...3d1bc6e0fe1a6b