Treadmill walking reduces pre-frontal activation in patients with Parkinson's disease

Publication date: Available online 28 March 2018
Source:Gait & Posture
Author(s): Pablo Cornejo Thumm, Inbal Maidan, Marina Brozgol, Shiran Shustak, Eran Gazit, Shirley Shema Shiratzki, Hagar Bernad-Elazari, Yoav Beck, Nir Giladi, Jeffrey M. Hausdorff, Anat Mirelman
BackgroundAmong patients with Parkinson’s disease (PD), gait is typically disturbed and less automatic. These gait changes are associated with impaired rhythmicity and increased prefrontal activation, presumably in an attempt to compensate for reduced automaticity.Research questionWe investigated whether during treadmill walking, when the pace is determined and fixed, prefrontal activation in patients with PD is lower, as compared to over-ground walking.MethodsTwenty patients with PD (age: 69.8 ± 6.5 yrs.; MoCA: 26.9 ± 2.4; disease duration: 7.9 ± 4.2 yrs) walked at a self-selected walking speed over-ground and on a treadmill. A wireless functional near infrared spectroscopy (fNIRS) system measured prefrontal lobe activation, i.e., oxygenated hemoglobin (Hb02) in the pre-frontal area. Gait was evaluated using 3D-accelerometers attached to the lower back and ankles (Opal™, APDM). Dynamic gait stability was assessed using the maximum Lyapunov exponent to investigate automaticity of the walking pattern.ResultsHb02 was lower during treadmill walking than during over-ground walking (p = 0.001). Gait stability was greater on the treadmill, compared to over-ground walking, in both the anteroposterior and medio-lateral axes (p<0.001).SignificanceThese findings support the notion that when gait is externally paced, prefrontal lobe activation is reduced in patients with PD, perhaps reflecting a reduced need for compensatory cognitive mechanisms.



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