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Effects of cognitive function on gait and dual tasking abilities in patients with Parkinson's disease suffering from motor response fluctuations.
Exp Brain Res. 2011 Jan; 208(2):169-79.EB

Abstract

Recent studies have demonstrated that cognitive loading aggravates the gait impairments that are typically seen in Parkinson's disease (PD). To better understand the relationship between cognition and gait in PD, we evaluated 30 subjects with PD who suffer from motor response fluctuations. The subjects were clinically and cognitively assessed using standard clinical (e.g., Unified Parkinson's Disease Rating Scale) and cognitive tests while in the "ON" period of the medication cycle. In addition, the subjects wore force-sensitive insoles to quantify the timing of the gait cycles during 80-m walks at a self-selected, comfortable pace during three randomly presented gait conditions: (1) usual-walking, (2) dual tasking (DT), performing serial 3 subtractions (DT_S3), and (3) DT_S7. Stride length, gait speed, gait variability and bilateral coordination of gait were affected by DT, compared to the usual-walking (P < 0.001) as was gait asymmetry (P = 0.024). Stepwise regression analyses showed that a subset of the cognitive performance scores accounted for the changes seen in the gait parameters during DT, e.g., set shifting capabilities as expressed by the Trial Making Test Scores (P < 0.001). Affect (e.g., anxiety) was not associated with DT-related gait changes. For most gait features, DT had a large impact on the DT_S3 condition with only minimal additional effect in the DT_S7 condition. These results demonstrate that the complex cognitive-motor interplay in the control of gait in patients with PD who suffer from motor response fluctuations has a profound and marked effect during DT conditions on gait variability, asymmetry and bilateral coordination, even in the "ON" state when patients are likely to be most active, mobile and vulnerable to the negative effects of dual tasking.

Authors+Show Affiliations

Movement Disorders Unit, Department of Neurology, Laboratory for Gait and Neurodynamcis, Tel-Aviv Sourasky Medical Center, 6 Weizmann St., Tel-Aviv 64239, Israel. meirp@tasmc.health.gov.ilNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21063692

Citation

Plotnik, Meir, et al. "Effects of Cognitive Function On Gait and Dual Tasking Abilities in Patients With Parkinson's Disease Suffering From Motor Response Fluctuations." Experimental Brain Research, vol. 208, no. 2, 2011, pp. 169-79.
Plotnik M, Dagan Y, Gurevich T, et al. Effects of cognitive function on gait and dual tasking abilities in patients with Parkinson's disease suffering from motor response fluctuations. Exp Brain Res. 2011;208(2):169-79.
Plotnik, M., Dagan, Y., Gurevich, T., Giladi, N., & Hausdorff, J. M. (2011). Effects of cognitive function on gait and dual tasking abilities in patients with Parkinson's disease suffering from motor response fluctuations. Experimental Brain Research, 208(2), 169-79. https://doi.org/10.1007/s00221-010-2469-y
Plotnik M, et al. Effects of Cognitive Function On Gait and Dual Tasking Abilities in Patients With Parkinson's Disease Suffering From Motor Response Fluctuations. Exp Brain Res. 2011;208(2):169-79. PubMed PMID: 21063692.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of cognitive function on gait and dual tasking abilities in patients with Parkinson's disease suffering from motor response fluctuations. AU - Plotnik,Meir, AU - Dagan,Yaacov, AU - Gurevich,Tanya, AU - Giladi,Nir, AU - Hausdorff,Jeffrey M, Y1 - 2010/11/10/ PY - 2010/08/15/received PY - 2010/10/18/accepted PY - 2010/11/11/entrez PY - 2010/11/11/pubmed PY - 2011/4/27/medline SP - 169 EP - 79 JF - Experimental brain research JO - Exp Brain Res VL - 208 IS - 2 N2 - Recent studies have demonstrated that cognitive loading aggravates the gait impairments that are typically seen in Parkinson's disease (PD). To better understand the relationship between cognition and gait in PD, we evaluated 30 subjects with PD who suffer from motor response fluctuations. The subjects were clinically and cognitively assessed using standard clinical (e.g., Unified Parkinson's Disease Rating Scale) and cognitive tests while in the "ON" period of the medication cycle. In addition, the subjects wore force-sensitive insoles to quantify the timing of the gait cycles during 80-m walks at a self-selected, comfortable pace during three randomly presented gait conditions: (1) usual-walking, (2) dual tasking (DT), performing serial 3 subtractions (DT_S3), and (3) DT_S7. Stride length, gait speed, gait variability and bilateral coordination of gait were affected by DT, compared to the usual-walking (P < 0.001) as was gait asymmetry (P = 0.024). Stepwise regression analyses showed that a subset of the cognitive performance scores accounted for the changes seen in the gait parameters during DT, e.g., set shifting capabilities as expressed by the Trial Making Test Scores (P < 0.001). Affect (e.g., anxiety) was not associated with DT-related gait changes. For most gait features, DT had a large impact on the DT_S3 condition with only minimal additional effect in the DT_S7 condition. These results demonstrate that the complex cognitive-motor interplay in the control of gait in patients with PD who suffer from motor response fluctuations has a profound and marked effect during DT conditions on gait variability, asymmetry and bilateral coordination, even in the "ON" state when patients are likely to be most active, mobile and vulnerable to the negative effects of dual tasking. SN - 1432-1106 UR - https://www.unboundmedicine.com/medline/citation/21063692/Effects_of_cognitive_function_on_gait_and_dual_tasking_abilities_in_patients_with_Parkinson's_disease_suffering_from_motor_response_fluctuations_ L2 - https://dx.doi.org/10.1007/s00221-010-2469-y DB - PRIME DP - Unbound Medicine ER -