scholarly journals Frontal vs. Posterior cognitive dysfunction: Does greater risk of dementia lead to a differential gait in Parkinson’s disease?

2019 ◽  
Vol 13 (1) ◽  
pp. 1-10
Author(s):  
Carolina R. A. Silveira ◽  
Eric A. Roy ◽  
Quincy J. Almeida
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Deficits ◽  
Dual Task ◽  
Brain Areas ◽  
Dual Task Condition ◽  
Double Support ◽  
Task Conditions ◽  
Base Of Support ◽  
Normal Cognition

Background: Gait impairment is suggested to predict the onset of dementia in Parkinson’s disease (PD). Interestingly, studies have shown that PD patients with cognitive deficits mediated by posterior brain areas are at greater risk of developing dementia than those with frontal deficits. Yet, it remains unknown whether PD patients with posterior cognitive deficits show differences in gait when compared to those with frontal deficits. Aim: This study aimed to compare gait of individuals with PD showing “posterior”, “frontal”, or no cognitive impairment (NCI). Methods: Based on a sample of 64 individuals with PD, median scores were calculated for three neuropsychological tests relying on “frontal” and three relying on “posterior” brain areas. Individuals assigned into the Frontal or Posterior groups showed at least 2 out of 3 scores lower than the median in frontal or posterior tests, respectively. Those with 0 or 1 score lower than the median were classified as NCI. Participants walked under single and dual task conditions. Results: All groups walked slower, with greater variability, wider base of support, and longer double support in the dual task condition.  Interpretation: PD patients with posterior cognitive deficits walk similarly to those with frontal deficits and those with normal cognition.

scholarly journals Regularity of kinematic data between single and dual-task treadmill walking in people with Parkinson’s disease

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Samira Ahmadi ◽  
Tarique Siragy ◽  
Julie Nantel
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Time Delay ◽  
Dual Task ◽  
Multiple Scales ◽  
Linear Acceleration ◽  
Center Of Gravity ◽  
Complexity Index ◽  
Gait Feature ◽  
Task Conditions

Abstract Background Regularity, quantified by sample entropy (SampEn), has been extensively used as a gait stability measure. Yet, there is no consensus on the calculation process and variant approaches, e.g. single-scale SampEn with and without incorporating a time delay greater than one, multiscale SampEn, and complexity index, have been used to calculate the regularity of kinematic or kinetic signals. The aim of the present study was to test the discriminatory performance of the abovementioned approaches during single and dual-task walking in people with Parkinson’s disease (PD). Methods Seventeen individuals with PD were included in this study. Participants completed two walking trials that included single and dual-task conditions. The secondary task was word searching with twelve words randomly appearing in the participants’ visual field. Trunk linear acceleration at sternum level, linear acceleration of the center of gravity, and angular velocity of feet, shanks, and thighs, each in three planes of motion were collected. The regularity of signals was computed using approaches mentioned above for single and dual-task conditions. Results Incorporating a time delay greater than one and considering multiple scales helped better distinguish between single and dual-task walking. For all signals, the complexity index, defined as the summary of multiscale SampEn analysis, was the most efficient discriminatory index between single-task walking and dual-tasking in people with Parkinson's disease. Specifically, the complexity index of the trunk linear acceleration of the center of gravity distinguished between the two walking conditions in all three planes of motion. Conclusions The significant results observed across the 24 signals studied in this study are illustrative examples of the complexity index’s potential as a gait feature for classifying different walking conditions.

The 2-Min Walk Test Detects Dual-Task Deficits in Individuals With Parkinson’s Disease

2019 ◽  
Vol 27 (6) ◽  
pp. 843-847 ◽  
Author(s):  
Anson B. Rosenfeldt ◽  
Amanda L. Penko ◽  
Andrew S. Bazyk ◽  
Matthew C. Streicher ◽  
Tanujit Dey ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Cognitive Task ◽  
The Self ◽  
Effective Model ◽  
Gait Velocity ◽  
Walk Test ◽  
Minimal Clinical Important Difference ◽  
Task Conditions

The aim of this project was to (a) evaluate the potential of the 2-min walk test to detect declines in gait velocity under dual-task conditions and (b) compare gait velocity overground and on a self-paced treadmill in Parkinson’s disease (PD). In total, 23 individuals with PD completed the 2-min walk test under single- and dual-task (serial 7s) conditions overground and on a self-paced treadmill. There was a significant decrease in gait velocity from single- to dual-task conditions overground (1.32 ± 0.22 to 1.10 ± 0.25 m/s; p < .001) and on the self-paced treadmill (1.24 ± 0.21 to 1.05 ± 0.25 m/s; p < .001). Overground and treadmill velocities were not statistically different from each other; however, differences approached or exceeded the minimal clinical important difference. The 2-min walk test coupled with a cognitive task provides an effective model of identifying dual-task declines in individuals with PD. Further studies comparing overground and self-paced treadmill velocity is warranted in PD.

scholarly journals A Review of Dual-Task Walking Deficits in People with Parkinson's Disease: Motor and Cognitive Contributions, Mechanisms, and Clinical Implications

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Valerie E. Kelly ◽  
Alexis J. Eusterbrock ◽  
Anne Shumway-Cook
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Functional Mobility ◽  
Therapeutic Interventions ◽  
Motor Tasks ◽  
Concurrent Tasks ◽  
Task Conditions ◽  
Gait Impairments

Gait impairments in Parkinson's disease (PD) are exacerbated under dual-task conditions requiring the simultaneous performance of cognitive or motor tasks. Dual-task walking deficits impact functional mobility, which often requires walking while performing concurrent tasks such as talking or carrying an object. The consequences of gait impairments in PD are significant and include increased disability, increased fall risk, and reduced quality of life. However, effective therapeutic interventions for dual-task walking deficits are limited. The goals of this narrative review are to describe dual-task walking deficits in people with PD, to discuss motor and cognitive factors that may contribute to these deficits, to review potential mechanisms underlying dual-task deficits, and to discuss the effect of therapeutic interventions on dual-task walking deficits in persons with PD.

scholarly journals Altered Cerebellar Resting-State Functional Connectivity in Early-Stage Parkinson's Disease Patients With Cognitive Impairment

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaojuan Dan ◽  
Yang Hu ◽  
Junyan Sun ◽  
Linlin Gao ◽  
Yongtao Zhou ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Functional Connectivity ◽  
Cognitive Deficits ◽  
Resting State ◽  
Early Stage ◽  
Cognitive Status ◽  
Elderly Subjects ◽  
Normal Cognition

Background: Cognitive impairment is one of the most prominent non-motor symptoms in Parkinson's disease (PD), due in part to known cerebellar dysfunctions. Furthermore, previous studies have reported altered cerebellar functional connectivity (FC) in PD patients. Yet whether these changes are also due to the cognitive deficits in PD remain unclear.Methods: A total of 122 non-dementia participants, including 64 patients with early PD and 58 age- and gender-matched elderly controls were stratified into four groups based on their cognitive status (normal cognition vs. cognitive impairment). Cerebellar volumetry and FC were investigated by analyzing, respectively, structural and resting-state functional MRI data among groups using quality control and quantitative measures. Correlation analysis between MRI metrics and clinical features (motor and cognitive scores) were performed.Results: Compared to healthy control subjects with no cognitive deficits, altered cerebellar FC were observed in early PD participants with both motor and cognitive deficits, but not in PD patients with normal cognition, nor elderly subjects showing signs of a cognitive impairment. Moreover, connectivity between the “motor” cerebellum and SMA was positively correlated with motor scores, while intracerebellar connectivity was positively correlated with cognitive scores in PD patients with cognitive impairment. No cerebellar volumetric difference was observed between groups.Conclusions: These findings show that altered cerebellar FC during resting state in early PD patients may be driven not solely by the motor deficits, but by cognitive deficits as well, hence highlighting the interplay between motor and cognitive functioning, and possibly reflecting compensatory mechanisms, in the early PD.

scholarly journals Standing balance in individuals with Parkinson's disease during single and dual-task conditions

2015 ◽  
Vol 42 (3) ◽  
pp. 323-328 ◽  
Author(s):  
Ângela Fernandes ◽  
Tiago Coelho ◽  
Ana Vitória ◽  
Augusto Ferreira ◽  
Rubim Santos ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Standing Balance ◽  
Task Conditions

Altered kinematics of arm swing in Parkinson's disease patients indicates declines in gait under dual-task conditions

2018 ◽  
Vol 48 ◽  
pp. 61-67 ◽  
Author(s):  
Elise I. Baron ◽  
Mandy Miller Koop ◽  
Matthew C. Streicher ◽  
Anson B. Rosenfeldt ◽  
Jay L. Alberts
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Arm Swing ◽  
Task Conditions

scholarly journals Goalkeeper game: a new assessment instrument in neurology showed higher predictive power than moca for gait performance in people with parkinson’s disease

2018 ◽  
Author(s):  
Rafael B. Stern ◽  
Matheus d’Alencar ◽  
Yanina L. Uscapi ◽  
Marco D. Gubitoso ◽  
Antonio C. Roque ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dual Task ◽  
Predictive Power ◽  
Assessment Instrument ◽  
Single Individual ◽  
Timed Up And Go ◽  
Gait Performance ◽  
Task Conditions ◽  
Moca Score

ObjectiveTo investigate the use of the Goalkeeper Game (GG) to assess gait automaticity decline under dual task conditions in people with Parkinson’s disease (PPD) and compare its predictive power with the one of the MoCA test.Materials and Methods74 PPD (H&Y stages: 23 in stage 1; 31 in stage 2; 20 in stage 3), without dementia (MoCA cut-off 23), tested in ON period with dopaminergic medication were submitted to single individual cognitive/motor evaluation sessions. The tests applied were: MoCA, GG, dynamic gait index (DGI) task and timed up and go test (TUG) under single and dual-task (DT) conditions. GG test resulted in 9 measures extracted via a statistical model. The predictive power of the GG measures and the MoCA score with respect to gait performance, as assessed by DGI and DT-TUG, were compared.ResultsThe predictive models based on GG measures and MoCA score obtained, respectively, sensitivities of 65% and 56% for DGI scores and 59% and 57% for DT-TUG cost at a 50% specificity. GG application proved to be feasible and aroused more motivation in PPDs than MoCa.ConclusionGG, a friendly and ludic game, was able to reach a good power of gait performance prediction in people at initial and intermediate stages of PD evolution.

scholarly journals Dual-Task Performance in GBA Parkinson’s Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Karin Srulijes ◽  
Kathrin Brockmann ◽  
Senait Ogbamicael ◽  
Markus A. Hobert ◽  
Ann-Kathrin Hauser ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Deficits ◽  
Dual Task ◽  
Rating Scale ◽  
Motor Task ◽  
Heterozygous Mutation ◽  
Dual Tasking ◽  
Dual Task Performance ◽  
Quantitative Gait Analysis

Introduction. Parkinson’s disease patients carrying a heterozygous mutation in the geneglucocerebrosidase(GBA-PD) show faster motor and cognitive decline than idiopathic Parkinson’s disease (iPD) patients, but the mechanisms behind this observation are not well understood. Successful dual tasking (DT) requires a smooth integration of motor and nonmotor operations. This study compared the DT performances between GBA-PD and iPD patients.Methods.Eleven GBA-PD patients (p.N370S, p.L444P) and eleven matched iPD patients were included. Clinical characterization included a motor score (Unified PD Rating Scale-III, UPDRS-III) and nonmotor scores (Montreal Cognitive Assessment, MoCA, and Beck’s Depression Inventory). Quantitative gait analysis during the single-task (ST) and DT assessments was performed using a wearable sensor unit. These parameters corrected for UPDRS and MoCA were then compared between the groups.Results.Under the DT condition “walking while checking boxes,” GBA-PD patients showed slower gait and box-checking speeds than iPD patients. GBA-PD and iPD patients did not show significant differences regarding dual-task costs.Conclusion. This pilot study suggests that DT performance with a secondary motor task is worse in GBA-PD than in iPD patients. This finding may be associated with the known enhanced motor and cognitive deficits in GBA-PD compared to iPD and should motivate further studies.

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