Which obstacle attributes place additional demands on higher-level cognitive function in patients with Parkinson's disease?

Background: Previous reports show that patients with Parkinson's disease (PD) rely on prefrontal activation to compensate for impaired motor function during complex activities such as obstacle negotiation. However, the influence of the properties of the obstacles on prefrontal activation has not bee...

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Publicado en:Parkinsonism & Related Disorders Vol. 78; pp. 178 - 184
Autores principales: Sharon, T., Kurz, I., Bernad-Elazari, H., Shustak, S., Galperin, I., Giladi, N., Mirelman, A., Hausdorff, J.M., Maidan, I.
Formato: research Journal Article
Publicado: Elsevier B.V. Sep2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2020
      vid: 78
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      pub: Elsevier B.V.
      place: New York, New York
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        147114580
        10.1016/j.parkreldis.2020.08.002
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        atl: Which obstacle attributes place additional demands on higher-level cognitive function in patients with Parkinson's disease?
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        au:
          Sharon, T.
          Kurz, I.
          Bernad-Elazari, H.
          Shustak, S.
          Galperin, I.
          Giladi, N.
          Mirelman, A.
          Hausdorff, J.M.
          Maidan, I.
        affil: Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel
      sug:
        subj:
          Frontal Lobe Physiopathology
          Mental Processes
          Parkinson Disease Physiopathology
          Spatial Perception
          Psychomotor Performance
          Motor Activity Physiology
          Human
          Brain Mapping
          Aged, 80 and Over
          Aged
          Middle Age
          Parkinson Disease Complications
          Female
          Spectroscopy, Near-Infrared
          Male
          Comparative Studies
          Multicenter Studies
          Evaluation Research
          Validation Studies
          Short Portable Mental Status Questionnaire
          Clinical Assessment Tools
          Aged, 80 & over
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: Previous reports show that patients with Parkinson's disease (PD) rely on prefrontal activation to compensate for impaired motor function during complex activities such as obstacle negotiation. However, the influence of the properties of the obstacles on prefrontal activation has not been systematically evaluated. Here, we examined the effects of obstacle height and anticipation time on prefrontal activation in patients with PD and older adults.Methods: 34 patients with PD (age: 67.4 ± 5.7 years; 14 women) and 26 older adults (age: 71.3 ± 8.9 years; 11 women) walked in an obstacle course while negotiating anticipated and unanticipated obstacles (long/short available time response, ART) at heights of 50 mm and 100 mm. Prefrontal activation was measured using functional Near-Infrared Spectroscopy (fNIRS); obstacle negotiation performance was measured using Kinect cameras.Results: PD patients showed greater increases in prefrontal activation during and after obstacle crossing compared to the older adults (p < 0.001). Obstacle height affected prefrontal activity only when crossing anticipated obstacles (ARTxheight interaction, p = 0.011), in which case higher obstacles were accompanied by higher prefrontal activity. PD patients showed higher levels of activation during unanticipated obstacles, compared to older adults (groupXART: p = 0.015). Different correlations between prefrontal activation and obstacle negotiation strategies were observed in patients and controls.Conclusions: These results point to the use of prefrontal activation as a compensatory mechanism in PD. Moreover, the higher activation observed when negotiating more challenging obstacles suggests that there is greater reliance on cognitive resources in these demanding situations that may contribute to the higher risk of falls in PD patients.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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