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Dual task activities in Parkinson's disease

Stefanie Lerche, Alexandra Gutfreund, Kathrin Brockmann, Markus A Hobert, Isabel Wurster, Ulrike Sünkel, Gerhard W Eschweiler, Florian G Metzger, Walter Maetzler, Daniela Berg
OBJECTIVE: The prevalence of Alzheimer's disease and Parkinson's disease increases with the raising number of elderly, which will be a challenging situation for the healthcare systems and society in the future. There is evidence that there are modifiable risk-factors e.g. physical activity for these diseases. Here, we study the interaction between sports inactivity with prodromal markers for neurodegeneration. PATIENTS AND METHODS: We investigated 667 neurologically healthy individuals cross-sectional and a subgroup longitudinal over six years...
January 9, 2018: Clinical Neurology and Neurosurgery
Linlin Gao, Jiarong Zhang, Yanan Hou, Mark Hallett, Piu Chan, Tao Wu
Parkinson's disease (PD) patients have difficulty in performing a dual-task. It has been suggested that the cerebellum is important in dual-tasking. We used functional MRI to investigate the role of the cerebellum in performing a dual motor and cognitive task in PD patients. We have examined whether there are any areas additionally activated for dual-task performance, and compared the neural activity and functional connectivity pattern in the cerebellum between PD patients and healthy controls. We found that the right cerebellar vermis and left lobule V of cerebellar anterior lobe were additionally activated for dual-task performance in healthy controls and for motor task in PD patients...
March 30, 2017: Scientific Reports
Freek Nieuwhof, Bastiaan R Bloem, Miriam F Reelick, Esther Aarts, Inbal Maidan, Anat Mirelman, Jeffrey M Hausdorff, Ivan Toni, Rick C Helmich
See Bell et al. (doi:10.1093/awx063) for a scientific commentary on this article. Impaired dual tasking, namely the inability to concurrently perform a cognitive and a motor task (e.g. 'stops walking while talking'), is a largely unexplained and frequent symptom of Parkinson's disease. Here we consider two circuit-level accounts of how striatal dopamine depletion might lead to impaired dual tasking in patients with Parkinson's disease. First, the loss of segregation between striatal territories induced by dopamine depletion may lead to dysfunctional overlaps between the motor and cognitive processes usually implemented in parallel cortico-striatal circuits...
May 1, 2017: Brain: a Journal of Neurology
David Conradsson, Håkan Nero, Niklas Löfgren, Maria Hagströmer, Erika Franzén
BACKGROUND: Despite the benefits of balance exercise in clinical populations, balance training programs tend to be poorly described, which in turn makes it difficult to evaluate important training components and compare between programs. However, the use of wearable sensors may have the potential to monitor certain elements of balance training. Therefore, this study aimed to investigate the feasibility of using wearable sensors to provide objective indicators of the levels and progression of training activity during gait-related balance exercise in individuals with Parkinson's disease...
January 31, 2017: BMC Neurology
Freek Nieuwhof, Miriam F Reelick, Inbal Maidan, Anat Mirelman, Jeffrey M Hausdorff, Marcel G M Olde Rikkert, Bastiaan R Bloem, Makii Muthalib, Jurgen A H R Claassen
BACKGROUND: Many patients with Parkinson's disease (PD) have difficulties in performing a second task during walking (i.e., dual task walking). Functional near-infrared spectroscopy (fNIRS) is a promising approach to study the presumed contribution of dysfunction within the prefrontal cortex (PFC) to such difficulties. In this pilot study, we examined the feasibility of using a new portable and wireless fNIRS device to measure PFC activity during different dual task walking protocols in PD...
2016: Pilot and Feasibility Studies
Ângela Fernandes, Andreia S P Sousa, Nuno Rocha, João Manuel R S Tavares
The aim of this study was to compare postural control strategies during gait initiation in single- and dual-task conditions in individuals in early stages of Parkinson's Disease (PD). The activation timing of tibialis anterior occurred significantly later in the individuals with PD than in the controls (p = .05), and a significant interaction between the groups, conditions and limbs was found (p = .027). Differences between the single- and dual-task conditions were observed for the activation timing of the tibialis anterior (p = ...
July 2017: Motor Control
Gustavo Christofoletti, Marie E McNeely, Meghan C Campbell, Ryan P Duncan, Gammon M Earhart
Mobility and gait limitations are major issues for people with Parkinson disease (PD). Identification of factors that contribute to these impairments may inform treatment and intervention strategies. In this study we investigated factors that predict mobility and gait impairment in PD. Participants with mild to moderate PD and without dementia (n=114) were tested in one session 'off' medication. Mobility measures included the 6-Minute Walk test and Timed-Up-and-Go. Gait velocity was collected in four conditions: forward preferred speed, forward dual task, forward fast as possible and backward walking...
October 2016: Human Movement Science
Breiffni Leavy, Kirsti Skavberg Roaldsen, Kamilla Nylund, Maria Hagströmer, Erika Franzén
Background: There is growing evidence for the positive effects of exercise training programs on balance control in Parkinson disease (PD). To be effective, balance training needs to be specific, progressive, and highly challenging. Little evidence exists, however, for how people with PD-related balance impairments perceive highly challenging and progressive balance training programs with dual-task components. Objective: The purpose of this study was to explore and describe perceptions of a highly challenging balance training program among people with mild to moderate PD...
January 1, 2017: Physical Therapy
Mi-Ae Park, Marie Foley Kijewski, Ronnie Keijzers, Mark Keijzers, Morgan C Lyon, Laura Horky, Stephen C Moore
PURPOSE: Noise levels of brain SPECT images are highest in central regions, due to preferential attenuation of photons emitted from deep structures. To address this problem, the authors have designed a novel collimator for brain SPECT imaging that yields greatly increased sensitivity near the center of the brain without loss of resolution. This hybrid collimator consisted of ultrashort cone-beam holes in the central regions and slant-holes in the periphery (USCB). We evaluated this collimator for quantitative brain imaging tasks...
August 2016: Medical Physics
Aaron Kucinski, Inge E M de Jong, Martin Sarter
Falls are a leading cause of death in the elderly and, in a majority of patients with Parkinson's disease (PD), the leading levodopa-insensitive cause of hospitalization and long-term care. Falling in PD has been attributed to degeneration of forebrain cholinergic neurons that, in interaction with striatal dopamine losses, impairs the cognitive control of balance, gait, and movement. We previously established an animal model of these dual cholinergic-dopaminergic losses ("DL rats") and a behavioral test system (Michigan Complex Motor Control Task, MCMCT) to measure falls associated with traversing dynamic surfaces and distractors...
January 2017: European Journal of Neuroscience
Ashlee M Hendy, Alex Tillman, Timo Rantalainen, Makii Muthalib, Liam Johnson, Dawson J Kidgell, Daniel Wundersitz, Peter G Enticott, Wei-Peng Teo
BACKGROUND: Parkinson's disease (PD) results from a loss of dopamine in the brain, leading to movement dysfunctions such as bradykinesia, postural instability, resting tremor and muscle rigidity. Furthermore, dopamine deficiency in PD has been shown to result in maladaptive plasticity of the primary motor cortex (M1). Progressive resistance training (PRT) is a popular intervention in PD that improves muscular strength and results in clinically significant improvements on the Unified Parkinson's Disease Rating Scale (UPDRS)...
July 19, 2016: Trials
Siobhan M Schabrun, Robyn M Lamont, Sandra G Brauer
OBJECTIVE: To investigate the feasibility and safety of a combined anodal transcranial direct current stimulation (tDCS) and dual task gait training intervention in people with Parkinson's Disease (PD) and to provide data to support a sample size calculation for a fully powered trial should trends of effectiveness be present. DESIGN: A pilot, randomized, double-blind, sham-controlled parallel group trial with 12 week follow-up. SETTING: A university physiotherapy department...
2016: PloS One
Elisa Pelosin, Carla Ogliastro, Giovanna Lagravinese, Gaia Bonassi, Anat Mirelman, Jeffrey M Hausdorff, Giovanni Abbruzzese, Laura Avanzino
The aim of this study was to address whether deficits in the central cholinergic activity may contribute to the increased difficulty to allocate attention during gait in the elderly with heightened risk of falls. We recruited 50 participants with a history of two or more falls (33 patients with Parkinson's Disease and 17 older adults) and 14 non-fallers age-matched adults. Cholinergic activity was estimated by means of short latency afferent inhibition (SAI), a transcranial magnetic stimulation (TMS) technique that assesses an inhibitory circuit in the sensorimotor cortex and is regarded as a global marker of cholinergic function in the brain...
2016: Frontiers in Aging Neuroscience
Hong Lei, Nima Toosizadeh, Michael Schwenk, Scott Sherman, Stephan Karp, Esther Sternberg, Bijan Najafi
BACKGROUND: Gait disorder, a key contributor to fall and poor quality of life, represents a major therapeutic challenge in Parkinson's disease (PD). The efficacy of acupuncture for PD remains unclear, largely due to methodological flaws and lack of studies using objective outcome measures. OBJECTIVE: To objectively assess the efficacy of electroacupuncture (EA) for gait disorders using body-worn sensor technology in patients with PD. METHODS: In this randomized pilot study, both the patients and assessors were masked...
2016: PloS One
Inbal Maidan, Freek Nieuwhof, Hagar Bernad-Elazari, Miriam F Reelick, Bas R Bloem, Nir Giladi, Judith E Deutsch, Jeffery M Hausdorff, Jurgen A H Claassen, Anat Mirelman
BACKGROUND: Gait is influenced by higher order cognitive and cortical control mechanisms. Functional near infrared spectroscopy (fNIRS) has been used to examine frontal activation during walking in healthy older adults, reporting increased oxygenated hemoglobin (HbO2) levels during dual task walking (DT), compared with usual walking. OBJECTIVE: To investigate the role of the frontal lobe during DT and obstacle negotiation, in healthy older adults and patients with Parkinson's disease (PD)...
November 2016: Neurorehabilitation and Neural Repair
Chad Swank, Jyutika Mehta, Christina Criminger
BACKGROUND: Parkinson's disease (PD) progressively impairs motor and cognitive function. Gait dysfunction in PD is exacerbated during dual task gait. Transcranial direct current stimulation (tDCS) may therapeutically benefit motor and cognitive deficits. We examined the effect of a bilateral tDCS protocol on dual task gait in people with PD. MATERIAL AND METHODS: Participants with PD between 50 and 80 years received two sessions of tDCS protocol (1 active, 1 sham) separated by 7days...
July 28, 2016: Neuroscience Letters
Marlieke Scholten, Rathinaswamy B Govindan, Christoph Braun, Bastiaan R Bloem, Christian Plewnia, Rejko Krüger, Alireza Gharabaghi, Daniel Weiss
OBJECTIVE: Freezing behavior is an unmet symptom in Parkinson's disease (PD), which reflects its complex pathophysiology. Freezing behavior can emerge when attentional capacity is reduced, i.e. under dual task interference. In this study, we characterized the cortical network signatures underlying the susceptibility to freezing during continuous finger tapping. METHODS: Fourteen PD patients with STN-DBS and thirteen age- and gender-matched healthy controls performed continuous tapping with the index finger as single motor task and during dual tasking...
June 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
I Maidan, K Rosenberg-Katz, Y Jacob, N Giladi, J E Deutsch, J M Hausdorff, A Mirelman
INTRODUCTION: Behavioral studies suggest that deficits in cognitive domains and sensory-motor processes associated with Parkinson's disease (PD) impair the ability to walk in complex environments. However, the neural correlates of locomotion in complex environments are still unclear. METHODS: Twenty healthy older adults (mean age 69.7 ± 1.3 yrs) and 20 patients with PD (mean age 72.9 ± 1.6 yrs; disease duration: 6.8 ± 1.3 yrs; UPDRSIII: 29.8 ± 2.4) were asked to imagine themselves walking while in the MRI scanner...
April 2016: Parkinsonism & related Disorders
Pieter Ginis, Alice Nieuwboer, Moran Dorfman, Alberto Ferrari, Eran Gazit, Colleen G Canning, Laura Rocchi, Lorenzo Chiari, Jeffrey M Hausdorff, Anat Mirelman
BACKGROUND: Inertial measurement units combined with a smartphone application (CuPiD-system) were developed to provide people with Parkinson's disease (PD) real-time feedback on gait performance. This study investigated the CuPiD-system's feasibility and effectiveness compared with conventional gait training when applied in the home environment. METHODS: Forty persons with PD undertook gait training for 30 min, three times per week for six weeks. Participants were randomly assigned to i) CuPiD, in which a smartphone application offered positive and corrective feedback on gait, or ii) an active control, in which personalized gait advice was provided...
January 2016: Parkinsonism & related Disorders
Helena Fernández-Lago, Olalla Bello, Virginia López-Alonso, José Andrés Sánchez, Luis Morenilla, Miguel Ángel Fernández-del-Olmo
OBJECTIVE: The aim of this study was to explore whether attentional demands are involved in gait improvements in Parkinson disease (PD) patients when they walk on a treadmill. DESIGN: Nineteen individuals with idiopathic PD and 19 age-matched healthy controls participated in this study. Participants walked on a treadmill and on overground under single task (walk only) and dual task (walk performing a simultaneous cognitive task) conditions. The dual-task paradigm was used to reveal the attention allocation behavior...
November 2015: American Journal of Physical Medicine & Rehabilitation
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