Abstract Details

Title Physiotherapy with Dual-Tasks Improves Cognition and Resting-State Functional Connectivity in Parkinson’s Disease with Postural Instability and Gait Disorders

Topic Neuro-rehabilitation

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 440

Objective To demonstrate whether dual-task training with Action Observation Training (AOT) and Motor Imagery (MI) ameliorates cognitive performance and resting-state (RS) brain functional connectivity (FC) in Parkinson’s disease (PD) patients with postural instability and gait disorders (PIGD).

Background AOT and MI are mental practice techniques targeted to improving, consolidating and recovering motor learning in PD, by facilitating motor and cognitive pathways.

Design/Methods 20 PD-PIGD patients were randomized into 2 groups: i) DUAL-TASK+AOT-MI group performed a 6-week training consisting of AOT-MI combined with practicing observed-imagined gait and balance exercises; ii) DUAL-TASK-group performed the same exercises combined with landscape-videos observation. All patients underwent a computerized cognitive assessment and RS-fMRI scans at baseline and after training. Cognitive and RS-FC changes (and their relationships) over time within and between-groups were assessed.

Results After training, all PD-PIGD improved in terms of accuracy and reaction times in test assessing executive-attentive (mainly dual-task) skills. The within-group analyses showed that: the DUAL-TASK+AOT-MI group had increased RS-FC within the Anterior Salience Network (aSAL), the right Executive Control Network and the Precuneus, and reduced RS-FC within the anterior Default Mode Network (aDMN); while the DUAL-TASK group showed increased RS-FC within the Visuospatial Network. GroupxTime interactions showed that, compared to the DUAL-TASK group, the DUAL-TASK+AOT-MI group showed increased RS-FC within the aSAL, which correlated to reduced response latency, and reduced RS-FC within the aDMN, which correlated to better accuracy in this group.

Conclusions In PD-PIGD patients, both trainings promote cognitive improvement and brain functional reorganization. The DUAL-TASK+AOT-MI training is further useful for obtaining specific functional reorganization of extra-motor brain networks involved in motor control and executive-attentive abilities with specific effects on dual-task mobility and balance.

Authors/Disclosures
Michela Leocadi, MSc (IRCCS San Raffaele Scientific Institute) PRESENTER	Dr. Leocadi has nothing to disclose.
Elisa Canu (Ospedale San Raffaele)	The institution of Elisa Canu has received research support from Italian Ministry of Health .
Elisabetta Sarasso	Elisabetta Sarasso has nothing to disclose.
Andrea Gardoni	No disclosure on file
Silvia Basaia	Silvia Basaia has nothing to disclose.
Veronica Castelnovo, MSc (San Raffaele Scientific Institute, Vita-Salute San Raffaele University)	Dr. Castelnovo has nothing to disclose.
M. Antonietta Volonte, MD	Dr. Volonte has nothing to disclose.
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.
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.

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