scholarly journals Higher-Level Cognitive Function and Obstacle Attributes: An fNIRS Study in Older Adults With Parkinson’s Disease

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 268-268
Author(s):  
Jeffrey Hausdorff ◽  
Topaz Sharon ◽  
Ilan Kurz ◽  
Hagar Bernad-Elazari ◽  
Ira Galperin ◽  
...  
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Near Infrared ◽  
Cognitive Resources ◽  
Compensatory Mechanism ◽  
Functional Near Infrared Spectroscopy ◽  
Negotiation Strategies ◽  
Risk Of Falls ◽  
Obstacle Height

Abstract Older adults with Parkinson’s disease (PD) rely on prefrontal activation to compensate for impaired motor function during the performance of complex mobility-related activities such as obstacle negotiation. However, the influence of the properties of the obstacles on prefrontal activation has not been systematically evaluated. Here, we examined the effects of obstacle height and anticipation time on prefrontal activation in patients with PD and older adults. 34 patients with PD (age: 67.4±5.7 years; 14 women) and 26 older adult controls (age: 71.3±8.9 years; 11 women) walked in an obstacle course while negotiating anticipated and unanticipated obstacles at heights of 50 mm and 100 mm. Prefrontal activation was measured using functional Near-Infrared Spectroscopy (fNIRS); obstacle negotiation performance was measured using Kinect cameras. PD patients showed greater increases in prefrontal activation during and after obstacle crossing compared to the older adults (p<0.001). Obstacle height affected prefrontal activity only when crossing anticipated obstacles (time x height interaction, p=0.011); in that case, higher obstacles were accompanied by higher prefrontal activity. PD patients showed higher levels of activation during unanticipated obstacles, compared to anticipated obstacles (p=0.015). Different correlations between prefrontal activation and obstacle negotiation strategies were observed in the patients and the controls. These results point to the use of prefrontal activation as a compensatory mechanism in PD. Moreover, the higher activation of prefrontal regions during more challenging obstacles suggests that there is a greater reliance on cognitive resources in these demanding situations that may contribute to the higher risk of falls in patients with PD.

People With Parkinson’s Disease Exhibit Reduced Cognitive and Motor Cortical Activity When Undertaking Complex Stepping Tasks Requiring Inhibitory Control

2020 ◽  
Vol 34 (12) ◽  
pp. 1088-1098
Author(s):  
Paulo H. S. Pelicioni ◽  
Stephen R. Lord ◽  
Yoshiro Okubo ◽  
Daina L. Sturnieks ◽  
Jasmine C. Menant
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Inhibitory Control ◽  
Near Infrared ◽  
Premotor Cortex ◽  
Cortical Activity ◽  
Cortical Activation ◽  
Functional Near Infrared Spectroscopy ◽  
Dorsolateral Prefrontal ◽  
Motor Cortical

Background People with Parkinson’s disease (PD) have difficulties generating quick and accurate steps in anticipation of and/or in response to environmental hazards. However, neural mechanisms underlying performance in cognitively demanding stepping tasks are unclear. Objective This study compared activation patterns in cognitive and motor cortical regions using functional near-infrared spectroscopy (fNIRS) between people with PD and age-matched healthy older adults (HOA) during stepping tasks. Methods Fifty-two people with PD and 95 HOA performed a simple choice stepping reaction time test (CSRT) and 2 cognitively demanding stepping tests (inhibitory CSRT [iCSRT] and Stroop stepping test [SST]) on a computerized step mat. Cortical activation in the dorsolateral prefrontal cortex (DLPFC), Broca’s area, supplementary motor area (SMA), and premotor cortex (PMC) were recorded using fNIRS. Stepping performance and cortical activity were contrasted between groups and between the CSRT and the iCSRT and SST. Results The PD group performed worse than the HOA in all 3 stepping tests. A consistent pattern of interactions indicated differential hemodynamic responses between the groups. Compared with the CSRT, the PD group exhibited reduced DLPFC activity in the iCSRT and reduced SMA and PMC activity in the SST. The HOA exhibited increased DLPFC, SMA, and PMC activity when performing the SST in comparison with the CSRT task. Conclusions In contrast to the HOA, the PD group demonstrated reduced cortical activity in the DLPFC, SMA, and PMC during the more complex stepping tasks requiring inhibitory control. This may reflect subcortical and/or multiple pathway damage with subsequent deficient use of cognitive and motor resources.

scholarly journals Golf as a Physical Activity to Potentially Reduce the Risk of Falls in Older Adults with Parkinson’s Disease

Sports ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 72
Author(s):  
Rebecca R. Bliss ◽  
Frank C. Church
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurodegenerative Disorder ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Advanced Age ◽  
Golf Club ◽  
Increased Risk ◽  
Risk Of Falls

Advanced age is associated with an increased risk for falls in aging adults. Older adults are also more likely to be diagnosed with Parkinson’s disease (PD), with advanced age as the most significant risk factor. PD is a neurodegenerative disorder with four Cardinal motor symptoms: rigidity, bradykinesia, postural instability, and tremor. Thus, people (person)-with-Parkinson’s disease (PwP) have an even greater risk of falling than non-disorder age-matched peers. Exercise is an activity requiring physical effort, typically carried out to sustain or improve overall health and fitness, and it lowers the risk of falls in the general population. The sport of golf provides a low-impact all-around workout promoting a range of motion, activation of muscles in the upper and lower body, flexibility, and balance. Swinging a golf club offers a unique combination of high amplitude axial rotation, strengthening postural musculature, coordination, and stabilization, demonstrating the potential to impact PD symptoms positively. Golf may be a novel exercise treatment regimen for PD to use in conjunction with traditional medical therapy. We completed a literature review to determine the relationship between the game of golf, PD, and the risk of falls. We concluded that regularly playing golf can lower the risk for falls in community ambulating older adults with PD and demonstrates the potential to improve quality of life for PwP.

Cerebral Hemodynamic Responses to the Difficulty Level of Ambulatory Tasks in Patients With Parkinson’s Disease: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 154596832110285
Author(s):  
Jin P. Lin ◽  
Hong S. Feng ◽  
Hua Zhai ◽  
Xia Shen
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Near Infrared ◽  
Cognitive Status ◽  
Cortical Activation ◽  
Difficulty Level ◽  
Hemodynamic Responses ◽  
Functional Near Infrared Spectroscopy ◽  
Cerebral Hemodynamic ◽  
Healthy Elderly

Background. Ambulatory tasks are the important components of balance training which effectively improve postural stability and functional activities in persons with Parkinson’s disease (PD). The difficulty level of an ambulatory task is usually set in the form of attention, direction, speed, or amplitude requirement. Objectives. This study aimed to explore the neural mechanisms of cerebral hemodynamic responses to the difficulty level of ambulatory tasks in persons with PD. Methods. We included ten studies that examined cerebral hemodynamic responses during ambulatory tasks at different difficulty levels in persons with PD. The change in hemodynamic responses was synthesized and meta-analyzed. Results. Patients during “ON” medication had higher relative change in oxygenated hemoglobin (ΔHBO2) in the prefrontal cortex in response to difficulty levels of ambulatory tasks, which is comparable to that in healthy elderly individuals. However, patients during “OFF” medication did not show cortical activation in response to difficulty levels. During the lower-difficulty tasks, patients during “ON” medication demonstrated higher ΔHBO2 than healthy elderly participants and patients during “OFF” medication. Factors found to significantly contribute to the heterogeneity across studies included subjects’ type and cognitive status, task duration, setting, and filter used for functional near-infrared spectroscopy (fNIRS) data pre-processing. Conclusions. The findings suggest that ambulatory task at a higher difficulty level could be necessary to train the cortical capacity of PD persons, which should be conducted during “ON” medication; meanwhile, the contributing factors to the heterogeneity of studies would be useful as a reference when designing comparable fNIRS studies.

Cognitive and Motor Dual Task on Multi-area Brain Activation and Gait Performance in Individuals with Parkinson’s Disease

2021 ◽  
Author(s):  
Yan-Ci Liu ◽  
Yea-Ru Yang ◽  
Nai-Chen Yeh ◽  
Pei-Hsin Ku ◽  
Chia-Feng Lu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Near Infrared ◽  
Cognitive Task ◽  
Premotor Cortex ◽  
Brain Activation ◽  
Functional Near Infrared Spectroscopy ◽  
Gait Performance ◽  
Walking Performance

Abstract Background In people with Parkinson’s disease (PD), gait performance deteriorating during dual task walking compared to single-task walking has been noted in previous studies. However, the effects of different types of dual task on gait performance and brain activation were still unknown. Methods This study investigated the walking performance changes and multi-area brain activities during cognitive and motor dual task walking in people with PD. Twenty-eight participants with PD were recruited and performed single walking (SW), walking while performing a cognitive task (WCT), and walking while performing a motor task (WMT) at their self-selected speed. Gait performance including walking speed, cadence, stride length, stride time, swing cycle, temporal and spatial variability and dual task cost (DTC) were recorded. Brain activation of the prefrontal cortex (PFC), premotor cortex (PMC), and supplementary motor areas (SMA) were measured by functional near-infrared spectroscopy during walking. Results Results showed the walking performance deteriorated upon performing a secondary task, especially the cognitive task. Also, a higher and sustained activation in PMC and SMA during WCT as compared with WMT and SW in the late phase of walking was found. Moreover, gait performance was negatively correlated with PMC and SMA activity during different walking tasks. Conclusions Individuals with PD demonstrated gait deterioration during dual task walking, especially WCT. The SMA and PMC were further activated in people with PD when performing cognitive dual task walking. Trial registrationTCTR20190118010. Registered 18 January 2019, retrospectively registered.

scholarly journals Executive Control of Walking in People With Parkinson’s Disease With Freezing of Gait

2020 ◽  
Vol 34 (12) ◽  
pp. 1138-1149
Author(s):  
Rodrigo Vitorio ◽  
Samuel Stuart ◽  
Martina Mancini
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Executive Control ◽  
Dual Task ◽  
Near Infrared ◽  
Inertial Sensors ◽  
Cognitive Task ◽  
Freezing Of Gait ◽  
Functional Near Infrared Spectroscopy ◽  
Indirect Measures

Background Walking abnormalities in people with Parkinson’s disease (PD) are characterized by a shift in locomotor control from healthy automaticity to compensatory prefrontal executive control. Indirect measures of automaticity of walking (eg, step-to-step variability and dual-task cost) suggest that freezing of gait (FoG) may be associated with reduced automaticity of walking. However, the influence of FoG status on actual prefrontal cortex (PFC) activity during walking remains unclear. Objective To investigate the influence of FoG status on automaticity of walking in people with PD. Methods Forty-seven people with PD were distributed into 2 groups based on FoG status, which was assessed by the New Freezing of Gait Questionnaire: PD−FoG (n = 23; UPDRS-III = 35) and PD+FoG (n = 24; UPDRS-III = 43.1). Participants walked over a 9-m straight path (with a 180° turn at each end) for 80 seconds. Two conditions were tested off medication: single- and dual-task walking (ie, with a concomitant cognitive task). A portable functional near-infrared spectroscopy system recorded PFC activity while walking (including turns). Wearable inertial sensors were used to calculate spatiotemporal gait parameters. Results PD+FoG had greater PFC activation during both single and dual-task walking than PD−FoG ( P = .031). There were no differences in gait between PD−FoG and PD+FoG. Both groups decreased gait speed ( P = .029) and stride length ( P < .001) during dual-task walking compared with single-task walking. Conclusions These findings suggest that PD+FoG have reduced automaticity of walking, even in absence of FoG episodes. PFC activity while walking seems to be more sensitive than gait measures in identifying reduction in automaticity of walking in PD+FoG.

Gait Disturbance Improvement and Cerebral Cortex Rearrangement by Acupuncture in Parkinson’s Disease: A Pilot Assessor-Blinded, Randomized, Controlled, Parallel-Group Trial

2020 ◽  
Vol 34 (12) ◽  
pp. 1111-1123
Author(s):  
Jung-Hee Jang ◽  
Sangsoo Park ◽  
Jinung An ◽  
Jong-duk Choi ◽  
In chan Seol ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cerebral Cortex ◽  
Conventional Therapy ◽  
Near Infrared ◽  
Rating Scale ◽  
Intervention Group ◽  
Gait Disturbance ◽  
Control Group ◽  
Functional Near Infrared Spectroscopy

Background Parkinson’s disease (PD) leads to impaired mobility and limited independence. Objective We investigated the effects of acupuncture on gait disturbance and analyzed hemodynamic changes caused by acupuncture in the cerebral cortex of patients with PD. Methods Participants (n = 26) with gait disturbance due to PD were randomly assigned to the intervention (acupuncture twice a week for 4 weeks + conventional therapy) or control (conventional therapy) groups. We analyzed gait parameters using the GAITRite system and hemodynamic responses in the cerebral cortices using functional near-infrared spectroscopy, Unified Parkinson’s Disease Rating Scale (UPDRS) scores, neurotransmitter levels, as well as the immediate effects of acupuncture in patients with PD. Results The participants tended to walk with hypometric gait (high cadence, short steps) overground. After acupuncture treatment, those in the intervention group showed a significant reduction in cadence and the UPDRS scores involving “walking and balance” compared with those in the control group ( P = .004 and P = .020, respectively); the stride, swing, and single support times were significantly increased ( P = .006, P = .001, and P = .001, respectively). Oxyhemoglobin levels in the intervention group while walking on a treadmill were significantly increased in the prefrontal and supplementary motor areas. The oxyhemoglobin levels in the prefrontal cortex and swing time revealed significant positive correlations. Conclusions Our findings indicated that acupuncture tended to improve hypometric gait and rearranged activation of the cerebral cortex. Thus, acupuncture may be a useful complementary treatment for gait disturbance, including hypometric gait, in patients with PD. Trial Registration Number. Clinical Research Information Service (KCT0002603), https://cris.nih.go.kr/cris/index.jsp

scholarly journals Changes in Prefrontal Cortical Activity During Walking and Cognitive Functions Among Patients With Parkinson's Disease

2020 ◽  
Vol 11 ◽  
Author(s):  
Maud Ranchet ◽  
Isabelle Hoang ◽  
Maxime Cheminon ◽  
Romain Derollepot ◽  
Hannes Devos ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Near Infrared ◽  
Early Stage ◽  
Cortical Activity ◽  
Cognitive Outcomes ◽  
Clinical Population ◽  
Group Status ◽  
Functional Near Infrared Spectroscopy ◽  
Dorsolateral Prefrontal

Background: Walking becomes more and more degraded as Parkinson's Disease (PD) progresses. Previous research examined factors contributing to this deterioration. Among them, changes in brain cortical activity during walking have been less studied in this clinical population.Objectives: This study aimed to: (1) investigate changes in dorsolateral prefrontal cortex (DLPFC) activation during usual walking and dual-task walking conditions in patients with PD; (2) examine the association between cortical activity and behavioral/cognitive outcomes; and (3) explore which factors best predict increased activation of the DLPFC during usual walking.Methods: Eighteen patients with early stage PD and 18 controls performed 4 conditions: (1) standing while subtracting, (2) usual walking, (3) walking while counting forward, and (4) walking while subtracting. Cortical activity in DLPFC, assessed by changes in oxy-hemoglobin (ΔHbO2) and deoxy-hemoglobin (ΔHbR), was measured using functional near infrared spectroscopy (fNIRS). Gait performance was recorded using wearables sensors. Cognition was also assessed using neuropsychological tests, including the Trail Making Test (TMT).Results: DLPFC activity was higher in patients compared to controls during both usual walking and walking while subtracting conditions. Patients had impaired walking performance compared to controls only during walking while subtracting task. Moderate-to-strong correlations between ΔHbO2 and coefficients of variation of all gait parameters were found for usual walking and during walking while counting forward conditions. Part-B of TMT predicted 21% of the variance of ΔHbO2 during usual walking after adjustment for group status.Conclusions: The increased DLPFC activity in patients during usual walking suggests a potential compensation for executive deficits. Understanding changes in DLPFC activity during walking may have implications for rehabilitation of gait in patients with PD.

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