Cortical Activity Underlying Gait Improvements Achieved With Dopaminergic Medication During Usual Walking and Obstacle Avoidance in Parkinson Disease

2021 ◽  
pp. 154596832110007
Author(s):  
Diego Orcioli-Silva ◽  
Rodrigo Vitório ◽  
Priscila Nóbrega-Sousa ◽  
Victor Spiandor Beretta ◽  
Núbia Ribeiro da Conceição ◽  
...  
Keyword(s):  
Parkinson Disease ◽  
Obstacle Avoidance ◽  
Posterior Parietal Cortex ◽  
Near Infrared ◽  
Step Length ◽  
Cortical Activity ◽  
Control Group ◽  
Functional Near Infrared Spectroscopy ◽  
Dopaminergic Medication ◽  
Gait Parameters

Background Dopaminergic medication improves gait in people with Parkinson disease (PD). However, it remains unclear if dopaminergic medication modulates cortical activity while walking. Objective We investigated the effects of dopaminergic medication on cortical activity during unobstructed walking and obstacle avoidance in people with PD. Methods A total of 23 individuals with PD, in both off (PDOFF) and on (PDON) medication states, and 30 healthy older adults (control group [CG]) performed unobstructed walking and obstacle avoidance conditions. Cortical activity was acquired through a combined functional near-infrared spectroscopy electroencephalography (EEG) system, along with gait parameters, through an electronic carpet. Prefrontal cortex (PFC) oxygenated hemoglobin (HbO2) and EEG absolute power from FCz, Cz, and CPz channels were calculated. Results HbO2 concentration reduced for people with PDOFF during obstacle avoidance compared with unobstructed walking. In contrast, both people with PDON and the CG had increased HbO2 concentration when avoiding obstacles compared with unobstructed walking. Dopaminergic medication increased step length, step velocity, and β and γ power in the CPz channel, regardless of walking condition. Moreover, dopaminergic-related changes (ie, on-off) in FCz/CPz γ power were associated with dopaminergic-related changes in step length for both walking conditions. Conclusions PD compromises the activation of the PFC during obstacle avoidance, and dopaminergic medication facilitates its recruitment. In addition, PD medication increases sensorimotor integration during walking by increasing posterior parietal cortex (CPz) activity. Increased γ power in the CPz and FCz channels is correlated with step length improvements achieved with dopaminergic medication during unobstructed walking and obstacle avoidance in PD.

scholarly journals Levodopa Facilitates Prefrontal Cortex Activation During Dual Task Walking in Parkinson Disease

2020 ◽  
Vol 34 (7) ◽  
pp. 589-599 ◽  
Author(s):  
Diego Orcioli-Silva ◽  
Rodrigo Vitório ◽  
Priscila Nóbrega-Sousa ◽  
Núbia Ribeiro da Conceição ◽  
Victor Spiandor Beretta ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Parkinson Disease ◽  
Dual Task ◽  
Near Infrared ◽  
Vigilance Task ◽  
Control Group ◽  
Functional Near Infrared Spectroscopy ◽  
Single Task ◽  
Dopaminergic Medication ◽  
Gait Parameters

Background. Although dopaminergic medication improves dual task walking in people with Parkinson disease (PD), the underlying neural mechanisms are not yet fully understood. As prefrontal cognitive resources are involved in dual task walking, evaluation of the prefrontal cortex (PFC) is required. Objective. To investigate the effect of dopaminergic medication on PFC activity and gait parameters during dual task walking in people with PD. Methods. A total of 20 individuals with PD (69.8 ± 5.9 years) and 30 healthy older people (68.0 ± 5.6 years) performed 2 walking conditions: single and dual task (walking while performing a digit vigilance task). A mobile functional near infrared spectroscopy system and an electronic sensor carpet were used to analyze PFC activation and gait parameters, respectively. Relative concentrations of oxygenated hemoglobin (HbO2) from the left and right PFC were measured. Results. People with PD in the off state did not present changes in HbO2 level in the left PFC across walking conditions. In contrast, in the on state, they presented increased HbO2 levels during dual task compared with single task. Regardless of medication state, people with PD presented increased HbO2 levels in the right PFC during dual task walking compared with single task. The control group demonstrated increased PFC activity in both hemispheres during dual task compared with single task. People with PD showed increases in both step length and velocity in the on state compared with the off state. Conclusions. PD limits the activation of the left PFC during dual task walking, and dopaminergic medication facilitates its recruitment.

Feasibility and Preliminary Efficacy of Gait Training Assisted by Multichannel Functional Electrical Stimulation in Early Stroke Rehabilitation: A Pilot Randomized Controlled Trial

2021 ◽  
Vol 35 (2) ◽  
pp. 131-144
Author(s):  
Maijke van Bloemendaal ◽  
Sicco A. Bus ◽  
Frans Nollet ◽  
Alexander C. H. Geurts ◽  
Anita Beelen
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Step Length ◽  
Gait Training ◽  
Control Group ◽  
Significant Group ◽  
Gait Symmetry ◽  
Gait Parameters ◽  
Walking Capacity ◽  
Experimental Group

Background. Many stroke survivors suffer from leg muscle paresis, resulting in asymmetrical gait patterns, negatively affecting balance control and energy cost. Interventions targeting asymmetry early after stroke may enhance recovery of walking. Objective. To determine the feasibility and preliminary efficacy of up to 10 weeks of gait training assisted by multichannel functional electrical stimulation (MFES gait training) applied to the peroneal nerve and knee flexor or extensor muscle on the recovery of gait symmetry and walking capacity in patients starting in the subacute phase after stroke. Methods. Forty inpatient participants (≤31 days after stroke) were randomized to MFES gait training (experimental group) or conventional gait training (control group). Gait training was delivered in 30-minute sessions each workday. Feasibility was determined by adherence (≥75% sessions) and satisfaction with gait training (score ≥7 out of 10). Primary outcome for efficacy was step length symmetry. Secondary outcomes included other spatiotemporal gait parameters and walking capacity (Functional Gait Assessment and 10-Meter Walk Test). Linear mixed models estimated treatment effect postintervention and at 3-month follow-up. Results. Thirty-seven participants completed the study protocol (19 experimental group participants). Feasibility was confirmed by good adherence (90% of the participants) and participant satisfaction (median score 8). Both groups improved on all outcomes over time. No significant group differences in recovery were found for any outcome. Conclusions. MFES gait training is feasible early after stroke, but MFES efficacy for improving step length symmetry, other spatiotemporal gait parameters, or walking capacity could not be demonstrated. Trial Registration. Netherlands Trial Register (NTR4762).

The effect of robot-assisted gait training on cortical activation in stroke patients: A functional near-infrared spectroscopy study

2021 ◽  
pp. 1-9
Author(s):  
Kyeong Joo Song ◽  
Min Ho Chun ◽  
Junekyung Lee ◽  
Changmin Lee
Keyword(s):  
Gait Speed ◽  
Functional Outcomes ◽  
Near Infrared ◽  
Gait Training ◽  
Berg Balance Scale ◽  
Cortical Activation ◽  
Control Group ◽  
Stroke Patients ◽  
Robot Assisted ◽  
Functional Near Infrared Spectroscopy

OBJECTIVE: To investigate the effects of the robot–assisted gait training on cortical activation and functional outcomes in stroke patients. METHODS: The patients were randomly assigned: training with Morning Walk® (Morning Walk group; n = 30); conventional physiotherapy (control group; n = 30). Rehabilitation was performed five times a week for 3 weeks. The primary outcome was the cortical activation in the Morning Walk group. The secondary outcomes included gait speed, 10-Meter Walk Test (10MWT), FAC, Motricity Index–Lower (MI–Lower), Modified Barthel Index (MBI), Rivermead Mobility Index (RMI), and Berg Balance Scale (BBS). RESULTS: Thirty-six subjects were analyzed, 18 in the Morning Walk group and 18 in the control group. The cortical activation was lower in affected hemisphere than unaffected hemisphere at the beginning of robot rehabilitation. After training, the affected hemisphere achieved a higher increase in cortical activation than the unaffected hemisphere. Consequently, the cortical activation in affected hemisphere was significantly higher than that in unaffected hemisphere (P = 0.036). FAC, MBI, BBS, and RMI scores significantly improved in both groups. The Morning Walk group had significantly greater improvements than the control group in 10MWT (P = 0.017), gait speed (P = 0.043), BBS (P = 0.010), and MI–Lower (P = 0.047) scores. CONCLUSION: Robot-assisted gait training not only improved functional outcomes but also increased cortical activation in stroke patients.

scholarly journals Estimation of temporal gait parameters of multiple sclerosis patients in clinical setting using inertial sensors

2016 ◽  
Author(s):  
Julius Griškevičius ◽  
Vigita Apanskienė ◽  
Jurgita Žižienė ◽  
Kristina Daunoravičienė ◽  
Agnė Ovčinikova ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Setting ◽  
Inertial Sensors ◽  
Early Stage ◽  
Step Length ◽  
Control Group ◽  
Permanent Disability ◽  
Gait Parameters ◽  
Healthy Control ◽  
Multiple Sclerosis Patients

Multiple sclerosis (MS) is the most frequent neurological disease causing permanent disability in young adults. Subtle walking difficulties, such as reduced walking speed, step length, cadence and increased step width can be detected at an early stage of the disease. Main goal of this research is by using non-invasive wireless inertial sensors measure gait of MS patients in clinical setting and extract temporal biomechanical parameters that would allow objectively evaluate level of disability in MS patients. Analysis of 25-Foot walk showed that the duration of stance phase is approximately 1.6 times greater in MS group than in healthy control group, while the duration of swing phase in MS group is 1.3 times longer. In general, the MS patients are walking approximately 1.6 times slower.

scholarly journals Detecting Fear of Heights Response to a Virtual Reality Environment Using Functional Near-Infrared Spectroscopy

2022 ◽  
Vol 3 ◽  
Author(s):  
Luciënne A. de With ◽  
Nattapong Thammasan ◽  
Mannes Poel
Keyword(s):  
Virtual Reality ◽  
Infrared Spectroscopy ◽  
Statistical Analysis ◽  
Near Infrared ◽  
Control Group ◽  
Fear Response ◽  
Functional Near Infrared Spectroscopy ◽  
Grand Average ◽  
Experimental Group ◽  
Fear Of Heights

To enable virtual reality exposure therapy (VRET) that treats anxiety disorders by gradually exposing the patient to fear using virtual reality (VR), it is important to monitor the patient's fear levels during the exposure. Despite the evidence of a fear circuit in the brain as reflected by functional near-infrared spectroscopy (fNIRS), the measurement of fear response in highly immersive VR using fNIRS is limited, especially in combination with a head-mounted display (HMD). In particular, it is unclear to what extent fNIRS can differentiate users with and without anxiety disorders and detect fear response in a highly ecological setting using an HMD. In this study, we investigated fNIRS signals captured from participants with and without a fear of height response. To examine the extent to which fNIRS signals of both groups differ, we conducted an experiment during which participants with moderate fear of heights and participants without it were exposed to VR scenarios involving heights and no heights. The between-group statistical analysis shows that the fNIRS data of the control group and the experimental group are significantly different only in the channel located close to right frontotemporal lobe, where the grand average oxygenated hemoglobin Δ[HbO] contrast signal of the experimental group exceeds that of the control group. The within-group statistical analysis shows significant differences between the grand average Δ[HbO] contrast values during fear responses and those during no-fear responses, where the Δ[HbO] contrast values of the fear responses were significantly higher than those of the no-fear responses in the channels located towards the frontal part of the prefrontal cortex. Also, the channel located close to frontocentral lobe was found to show significant difference for the grand average deoxygenated hemoglobin contrast signals. Support vector machine-based classifier could detect fear responses at an accuracy up to 70% and 74% in subject-dependent and subject-independent classifications, respectively. The results demonstrate that cortical hemodynamic responses of a control group and an experimental group are different to a considerable extent, exhibiting the feasibility and ecological validity of the combination of VR-HMD and fNIRS to elicit and detect fear responses. This research thus paves a way toward the a brain-computer interface to effectively manipulate and control VRET.

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