scholarly journals Pathological Gait Signatures of Post-stroke Dementia With Toe-Off and Heel-to-Ground Angles Discriminate From Alzheimer’s Disease

2021 ◽  
Vol 13 ◽  
Author(s):  
Linhui Ni ◽  
Wen Lv ◽  
Di Sun ◽  
Yi Sun ◽  
Yu Sun ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Dual Task ◽  
Stride Length ◽  
Statistical Significance ◽  
Swing Phase ◽  
Post Stroke ◽  
Gait Characteristics ◽  
Gait Parameters ◽  
Demographic Covariates

Given the limited power of neuropsychological tests, there is a need for a simple, reliable means, such as gait, to identify mild dementia and its subtypes. However, gait characteristics of patients with post-stroke dementia (PSD) and Alzheimer’s disease (AD) are unclear. We sought to describe their gait signatures and to explore gait parameters distinguishing PSD from post-stroke non-dementia (PSND) and patients with AD. We divided 3-month post-stroke patients into PSND and PSD groups based on the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and the activity of daily living (ADL). Thirty-one patients with AD and thirty-two healthy controls (HCs) were also recruited. Ten gait parameters in one single and two dual-task gait tests (counting-backward or naming-animals while walking) were compared among the groups, with adjustment for baseline demographic covariates and the MMSE score. The area under the receiver operating characteristic curve (AUC) was used to identify parameters discriminating PSD from individuals with PSND and AD. Patients with PSD and patients with AD showed impaired stride length, velocity, stride time, and cadence while patients with PSD had altered stance and swing phase proportions (all p ≤ 0.01, post hoc). Patients with AD had smaller toe-off (ToA) and heel-to-ground angles (HtA) (p ≤ 0.01) than HCs in dual-task gait tests. Individuals with PSD had a shorter stride length, slower velocity, and altered stance and swing phase percentages in all tests (p ≤ 0.01), but a higher coefficient of variation of stride length (CoVSL) and time (CoVST) only in the naming animals-task gait test (p ≤ 0.001) than individuals with PSND. ToA and HtA in the naming animals-task gait test were smaller in individuals with AD than those with PSD (p ≤ 0.01). Statistical significance persisted after adjusting for demographic covariates, but not for MMSE. The pace and the percentage of stance or swing phase in all tests, CoVST in the dual-task paradigm, and CoVSL only in the naming animals-task gait test (moderate accuracy, AUC > 0.700, p ≤ 0.01) could distinguish PSD from PSND. Furthermore, the ToA and HtA in the naming animals-task gait paradigm discriminated AD from PSD (moderate accuracy, AUC > 0.700, p ≤ 0.01). Thus, specific gait characteristics could allow early identification of PSD and may allow non-invasive discrimination between PSD and AD, or even other subtypes of dementia.

scholarly journals A-26 Performance on Design Fluency and Visuoperception Measures is Related to Single and Dual Task Treadmill Gait Parameters in Healthy Adults

2019 ◽  
Vol 34 (6) ◽  
pp. 885-885
Author(s):  
L Wadia ◽  
C Higginson ◽  
M Bifano ◽  
K Seymour ◽  
R Orr ◽  
...  
Keyword(s):  
Dual Task ◽  
Stride Length ◽  
Block Design ◽  
Healthy Adults ◽  
Step Width ◽  
Single Task ◽  
Gait Characteristics ◽  
Gait Parameters ◽  
Design Fluency ◽  
Task Step

Abstract Objective Research suggests a link between gait and cognition. Executive functions have been related to gait speed, however the relation between design fluency and visuoperception and other spatiotemporal gait characteristics that are related to falling is unclear. The objective of the study was to determine whether performance on design fluency and visuoperception tasks is related to spatiotemporal gait parameters during single and dual task treadmill walking in a sample of healthy adults. Method Nineteen healthy adults averaging 40 years of age completed cognitive measures of design fluency, visual attention, and visuoperception. They underwent gait analysis while walking on an instrumented treadmill in single task and dual task conditions. Results Performance on Spatial Span significantly correlated with single task stride length, r = 0.47, p = 0.043. Performance on Block Design significantly correlated with dual task stride length, r = 0.46, p = 0.049. Performance on Design Fluency significantly correlated with single task stride length variability, r = -0.50, p = 0.030, dual task stride length variability, r = -0.62, p = 0.005, and dual task step width variability, r = -0.56, p = 0.012. Performance on Picture Completion also correlated with dual task step width variability, r = -0.54, p = 0.017. Conclusions Design fluency and visuoperception appear related to spatiotemporal gait parameters in healthy adults. Worse cognitive performance was related to greater variability in dual task stride length and step width, gait characteristics associated with falling in aging and neurological populations.

P3-097: GAIT CHARACTERISTICS IN ALZHEIMER'S DISEASE AND FRONTOTEMPORAL DEMENTIA PATIENTS DURING DUAL TASK WALKING

2014 ◽  
Vol 10 ◽  
pp. P663-P663
Author(s):  
Gorana Mandic Stojmenovic ◽  
Elka Stefanova ◽  
Sasa Radovanovic ◽  
Vladimir Kostic
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Frontotemporal Dementia ◽  
Dual Task ◽  
Gait Characteristics ◽  
Dementia Patients

scholarly journals Longitudinal Changes in Temporospatial Gait Characteristics during the First Year Post-Stroke

2021 ◽  
Vol 11 (12) ◽  
pp. 1648
Author(s):  
John W. Chow ◽  
Dobrivoje S. Stokic
Keyword(s):  
Lower Extremity ◽  
Gait Speed ◽  
Stride Length ◽  
Double Support ◽  
Post Stroke ◽  
Gait Characteristics ◽  
Gait Parameters ◽  
Support Time ◽  
Post Onset ◽  
Step Parameters

Given the paucity of longitudinal data in gait recovery after stroke, we compared temporospatial gait characteristics of stroke patients during subacute (<2 months post-onset, T0) and at approximately 6 and 12 months post-onset (T1 and T2, respectively) and explored the relationship between gait characteristics at T0 and the changes in gait speed from T0 to T1. Forty-six participants were assessed at T0 and a subsample of 24 participants at T2. Outcome measures included Fugl-Meyer lower-extremity motor score, 14 temporospatial gait parameters and symmetry indices of 5 step parameters. Except for step width, all temporospatial parameters improved from T0 to T1 (p ≤ 0.0001). Additionally, significant improvements in symmetry were found for the initial double-support time and single-support time (p ≤ 0.0001). Although group results at T2 were not different from those at T1, the individual analysis revealed that 42% (10/24) of the subsample showed a significant increase in gait speed. The increase in gait speed from T0 to T1 was negatively correlated with gait speed and stride length, and positively correlated with the symmetry indices of stance and single-support times at T0 (p ≤ 0.002). Temporospatial gait parameters and stance time symmetry improve over the first 6 months after stroke with an apparent plateau thereafter. Approximately 40% of the subsample continue to increase gait speed from 6 to 12 months post-stroke. A greater increase in gait speed during the first 6 months post-stroke is associated with initially slower walking, shorter stride length, and more pronounced asymmetry in stance and single-support times. The improvement in lower-extremity motor function and bilateral improvements in step parameters collectively suggest that gait changes over the first 12 months after stroke are likely due to neurological recovery, although some compensation by the non-paretic side cannot be excluded.

Digital Biomarkers of Cognitive Frailty: The Value of Detailed Gait Assessment Beyond Gait Speed

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
He Zhou ◽  
Catherine Park ◽  
Mohammad Shahbazi ◽  
Michele K. York ◽  
Mark E. Kunik ◽  
...  
Keyword(s):  
Older Adults ◽  
Steady State ◽  
Dual Task ◽  
Gait Speed ◽  
Stride Length ◽  
Cognitive Frailty ◽  
Single Task ◽  
Double Support ◽  
Gait Parameters ◽  
Digital Biomarkers

<b><i>Background:</i></b> Cognitive frailty (CF), defined as the simultaneous presence of cognitive impairment and physical frailty, is a clinical symptom in early-stage dementia with promise in assessing the risk of dementia. The purpose of this study was to use wearables to determine the most sensitive digital gait biomarkers to identify CF. <b><i>Methods:</i></b> Of 121 older adults (age = 78.9 ± 8.2 years, body mass index = 26.6 ± 5.5 kg/m<sup>2</sup>) who were evaluated with a comprehensive neurological exam and the Fried frailty criteria, 41 participants (34%) were identified with CF and 80 participants (66%) were identified without CF. Gait performance of participants was assessed under single task (walking without cognitive distraction) and dual task (walking while counting backward from a random number) using a validated wearable platform. Participants walked at habitual speed over a distance of 10 m. A validated algorithm was used to determine steady-state walking. Gait parameters of interest include steady-state gait speed, stride length, gait cycle time, double support, and gait unsteadiness. In addition, speed and stride length were normalized by height. <b><i>Results:</i></b> Our results suggest that compared to the group without CF, the CF group had deteriorated gait performances in both single-task and dual-task walking (Cohen’s effect size <i>d</i> = 0.42–0.97, <i>p</i> &#x3c; 0.050). The largest effect size was observed in normalized dual-task gait speed (<i>d</i> = 0.97, <i>p</i> &#x3c; 0.001). The use of dual-task gait speed improved the area under the curve (AUC) to distinguish CF cases to 0.76 from 0.73 observed for the single-task gait speed. Adding both single-task and dual-task gait speeds did not noticeably change AUC. However, when additional gait parameters such as gait unsteadiness, stride length, and double support were included in the model, AUC was improved to 0.87. <b><i>Conclusions:</i></b> This study suggests that gait performances measured by wearable sensors are potential digital biomarkers of CF among older adults. Dual-task gait and other detailed gait metrics provide value for identifying CF above gait speed alone. Future studies need to examine the potential benefits of gait performances for early diagnosis of CF and/or tracking its severity over time.

P4-158: Dual-task gait performance in mild cognitive impairment may predict Alzheimer's disease conversion

2013 ◽  
Vol 9 ◽  
pp. P764-P764
Author(s):  
Mei Sian Chong ◽  
Laura Tay ◽  
Peng Chew Mark Chan ◽  
Noorhazlina Ali ◽  
Pamela Chew ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Dual Task ◽  
Gait Performance

scholarly journals Lexical semantic memory in amnestic mild cognitive impairment and mild Alzheimer's disease

2007 ◽  
Vol 65 (3a) ◽  
pp. 619-622 ◽  
Author(s):  
Marcio L.F. Balthazar ◽  
José E. Martinelli ◽  
Fernando Cendes ◽  
Benito P. Damasceno
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Semantic Memory ◽  
Statistical Significance ◽  
Verbal Learning ◽  
Amnestic Mild Cognitive Impairment ◽  
Memory Tests ◽  
Lexical Semantic

OBJECTIVE: To study lexical semantic memory in patients with amnestic mild cognitive impairment (aMCI), mild Alzheimer's disease (AD) and normal controls. METHOD: Fifteen mild AD, 15 aMCI, and 15 normal control subjects were included. Diagnosis of AD was based on DSM-IV and NINCDS-ADRDA criteria, and that of aMCI, on the criteria of the International Working Group on Mild Cognitive Impairment, using CDR 0.5 for aMCI and CDR 1 for mild AD. All subjects underwent semantic memory tests (Boston Naming-BNT, CAMCOG Similarities item), Rey Auditory Verbal Learning Test (RAVLT), Mini-Mental Status Examination (MMSE), neuropsychological tests (counterproofs), and Cornell Scale for Depression in Dementia. Data analysis used Mann-Whitney test for intergroup comparisons and Pearson's coefficient for correlations between memory tests and counterproofs (statistical significance level was p<0.05). RESULTS: aMCI patients were similar to controls on BNT and Similarities, but worse on MMSE and RAVLT. Mild AD patients scored significantly worse than aMCI and controls on all tests. CONCLUSION: aMCI impairs episodic memory but tends to spare lexical semantic system, which can be affected in the early phase of AD.

Dual task effects of walking when talking in Alzheimer's disease

2004 ◽  
Vol 160 (1) ◽  
pp. 74-80 ◽  
Author(s):  
G. Cocchini ◽  
S. Della Sala ◽  
R.H. Logie ◽  
R. Pagani ◽  
L. Sacco ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Dual Task ◽  
Task Effects

scholarly journals Conformation-selective tau monoclonal antibodies inhibit tau pathology in primary neurons and a mouse model of Alzheimer’s disease

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Garrett S. Gibbons ◽  
Soo-Jung Kim ◽  
Qihui Wu ◽  
Dawn M. Riddle ◽  
Susan N. Leight ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Monoclonal Antibodies ◽  
Statistical Significance ◽  
Neuritic Plaque ◽  
Plaque Burden ◽  
Primary Neurons ◽  
Tau Pathology ◽  
Model Of Alzheimer’S Disease

Abstract Background The spread of tau pathology in Alzheimer’s disease (AD) is mediated by cell-to-cell transmission of pathological tau seeds released from neurons that, upon internalization by recipient neurons, template the misfolding of naïve cellular tau, thereby propagating fibrillization. We hypothesize that anti-tau monoclonal antibodies (mAbs) that selectively bind to pathological tau seeds will inhibit propagation of tau aggregates and reduce the spread of tau pathology in vivo. Methods We inoculated mice with human AD brain-derived extracts containing tau paired helical filaments (AD-tau) and identified two novel mAbs, DMR7 and SKT82, that selectively bind to a misfolded pathological conformation of tau relative to recombinant tau monomer. To evaluate the effects of these mAbs on the spread of pathological tau in vivo, 5xFAD mice harboring significant brain Aβ plaque burden were unilaterally injected with AD-tau in the hippocampus, to initiate the formation of neuritic plaque (NP) tau pathology, and were treated weekly with intraperitoneal (i.p.) injections of DMR7, SKT82, or IgG isotype control mAbs. Results DMR7 and SKT82 bind epitopes comprised of the proline-rich domain and c-terminal region of tau and binding is reduced upon disruption of the pathological conformation of AD-tau by chemical and thermal denaturation. We found that both DMR7 and SKT82 immunoprecipitate pathological tau and significantly reduce the seeding of cellular tau aggregates induced by AD-tau in primary neurons by 60.5 + 13.8% and 82.2 + 8.3%, respectively, compared to IgG control. To investigate the mechanism of mAb inhibition, we generated pH-sensitive fluorophore-labeled recombinant tau fibrils seeded by AD-tau to track internalization of tau seeds and demonstrate that the conformation-selective tau mAbs inhibit the internalization of tau seeds. DMR7 and SKT82 treatment reduced hyperphosphorylated NP tau as measured with AT8 immunohistochemistry (IHC) staining, but did not achieve statistical significance in the contralateral cortex and SKT82 significantly reduced tau pathology in the ipsilateral hippocampus by 24.2%; p = 0.044. Conclusions These findings demonstrate that conformation-selective tau mAbs, DMR7 and SKT82, inhibit tau pathology in primary neurons by preventing the uptake of tau seeds and reduce tau pathology in vivo, providing potential novel therapeutic candidates for the treatment of AD.

Sign in / Sign up

Export Citation Format

Share Document