Abstract Details

Title Dual-Task in Parkinson’s Disease: A Gait Analysis and Functional MRI Study

Topic Movement Disorders

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-013

Objective To study gait parameters and functional MRI (fMRI) patterns performing dual-task in Parkinson’s disease patients with postural instability and gait disorders phenotype (PD-PIGD) and to assess correlations between brain functional activity and gait during dual-task.

Background Previous studies suggested that PD patients need to hyper-activate brain cognitive networks to control movement. Thus dual-task performance is usually difficult for PD patients, resulting in increased gait difficulties and postural instability.

Design/Methods Twenty PD-PIGD patients performed Timed-Up-and-Go (TUG) test, TUG with motor (TUG-MOT) and cognitive (TUG-COG) dual-tasks. TUG-MOT consisted of TUG while holding a glass full of water and TUG-COG consisted of TUG while counting backwards by threes starting from 100. A six cameras SMART-DX7000 optoelectronic system was used to obtain peak and mean velocity during the turning phase. Patients performed also two fMRI tasks: i) motor-task (foot anti-phase movements); ii) dual-task (foot anti-phase movements while counting backwards by threes starting from 100).

Results PD-PIGD patients showed increased total time of execution and slower turns during TUG-MOT and TUG-COG relative to simple TUG. During fMRI dual-task relative to motor-task, patients showed increased activation of the fronto-temporo-parietal regions and decreased activity of the sensorimotor areas. Correlation analysis showed that: i) better TUG performance correlated with increased recruitment of the cortical/cerebellar motor areas, the fronto-striatal circuit and the occipital lobe during the motor-task; ii) better TUG-MOT/TUG-COG performance correlated with increased activity of motor areas and decreased recruitment of superior/middle frontal and temporal gyri, superior/inferior parietal gyri, occipital areas and right pallidum during the dual-task.

Conclusions

Dual-task resulted in a slower gait performance particularly during turning, a challenging situation in PD-PIGD patients. This pattern might reflect an increased dynamic postural instability when high cognitive load is requested. FMRI results suggest that an optimized recruitment of motor and cognitive networks is associated with a better dual-task performance.

Authors/Disclosures
Elisabetta Sarasso PRESENTER	Elisabetta Sarasso has nothing to disclose.
Federica Agosta (San Raffaele Scientific Institute)	Federica Agosta has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Philips. Federica Agosta has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier INC.
Andrea Gardoni	No disclosure on file
Sebastiano Galantucci (San Raffaele Scientific Institute)	Mr. Galantucci has nothing to disclose.
Andrea Tettamanti	No disclosure on file
	No disclosure on file
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.

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