Virtual Reality for Parkinson's Disease
Virtual Reality for Parkinson's Disease
Parkinson's Disease (PD) is one of the most common neurodegenerative disease. Bradykinesia,
 tremor, resting tremor and postural instability are the main motor characteristics of this
 disease. As the disease progresses, mobility, walking, balance are reducing, the risk of
 falls is increasing and patients become functionally dependent. Along with these symptoms,
 cognitive functions are also disturbed. The most commonly distorted cognitive functions are
 executive functions such as planning and reasoning, working memory, episodic memory,
 attention and visual-spatial skills. Pharmacological and surgical treatments are used in
 Parkinson's disease. Pharmacologic treatment has a proven effect on motor symptoms, but since
 there is no approved pharmacologic treatment which has a direct effect on cognitive
 functions, recent studies suggest non-pharmacological treatments to improve cognitive
 function. Physiotherapy is also accepted among non-pharmacological treatments. Conventional
 physiotherapy focuses on optimizing patient independence and safety, focusing on hinting
 strategies, cognitive movement strategies and exercises utilizing transfers, posture, upper
 extremity function, balance (and falls), gait, physical capacity and (in)activity. Virtual
 Reality (VR) technology, a promising commonly used new rehabilitation tool, is a treatment
 method that can be used as one of the non-pharmacological treatment methods in Parkinson's
 Disease. In order to understand how neuronal network dysfunction in the Parkinson's Disease
 leads to clinical symptoms, both the component elements and the interconnections within these
 networks need to be examined in greater detail. Studies of resting state-fMRI (rs-fMRI) use
 correlation of activation of brain regions and time series fluctuations between brain regions
 to give information about connectivity in brain.

 The purpose of this study is to investigate the therapeutic effects of virtual reality on
 motor and cognitive symptoms of PD. Furthermore, the investigation of possible effects of
 this effect on neuroplasticity through functional brain networks is our other objective. This
 study will be the first study to evaluate the plasticity effect of virtual reality
 application with rs-fMRI in Parkinson's disease.
Inclusion Criteria:

 -  To be 50 years old and older

 -  Clinical diagnosis of PD within the -framework of Brain Bank criteria

 -  MoCa score ≥ 21

 -  Getting a stable antiparkinsonian medication at least for the last 1 month (or the
 treatment has not changed)

 Exclusion Criteria:

 -  Having a story of unstable medical condition

 -  History of head trauma, stroke, or exposure to toxic substances

 -  Implying Parkinson plus syndromes in neurological examinations; pyramidal, cerebellar
 examination findings, gaze paresis, autonomic dysfunction

 -  Being diagnosed with Dementia