Objective: To better understand how different attention networks contribute to walking.

Background: Parkinson’s disease (PD) is often characterized by effortful, fall-prone walking. PD can also lead to problems with attention, which consists of several independent brain networks and functions (alerting/vigilance, orienting/selective attention, and executive control). Dual-task walking paradigms assessing the contribution of attention to walking have suggested that executive function (EF) has a role in walking performance. Less is known about the contributions of other attention systems; thus, the purpose of this study was to evaluate the role of diverse attention systems in walking in PD using a dual-task paradigm.

Method: A PD group (n = 15, M_age = 68 years, M_MoCA = 26.1, M_{Hoehn & Yahr} = 1.5, M_UPDRS-III = 29.3) and a matched control group without PD (n = 15, M_age = 67 years, M_MoCA = 26.7), completed a computerized attention assessment battery followed by a dual-task walking (DTW) protocol, in which a sensor mat was used to measure both single walking (SW) and DTW while performing an auditory n-back task. Cognitive and walking performance were compared in single and dual-task conditions between groups, and attention predictors of walking were analyzed using linear regression.

Results: The PD group had significantly worse EF domain scores, Cohen’s d = −0.43 [−0.73, −0.13], and worse performance on tasks of vigilance and working memory, p < .01. Velocity (cm/s) was slower in the PD group during SW (PD vs controls, M = 101 vs. 120, p < .05). Both groups had slower velocity with DTW (M = 98 vs. 111, p < .001), with no difference in dual-task costs in velocity (M = −15 vs. −11, p = .21), nor differences in dual-task costs for n-back reaction time (M = −32 vs. −23 ms, p = .51) or accuracy (M = −3% vs. −4%, p = .91). EF domain scores significantly predicted SW velocity over group, p < .05, ΔR² = .12. Group and vigilance domain scores significantly predicted DTW costs, p < .05, R² = .22.

Conclusion: PD is associated with decline in both cognitive and walking abilities. Different domains of attention appear to be involved in walking, depending upon the task, at least in the early stages of PD. Our results provide a more fine-grained analysis of the attention functions in PD, highlighting the need to include a broader range of attention variables in assessment for clinical and research investigations of walking.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-role-of-attention-networks-in-walking-in-parkinsons-disease/