Objective: This study aims to investigate the relationship between executive function and gait in PSP using clinical assessments and objective gait analysis with wearable sensors. We explore whether these relationships are sustained longitudinally.

Background: Gait disturbance is an important diagnostic criterion for Progressive Supranuclear Palsy (PSP) and indicates poor quality of life. Executive function, involved in the complex control of gait behaviors, is commonly impaired in PSP and is linked with tau protein accumulation. Deficits in this cognitive domain may be associated with more severe gait symptoms in PSP.

Method: Twenty-six participants with PSP were recruited as part of the OxQUIP study, and 17 of them were followed up longitudinally over five visits at three-month intervals. Clinical symptoms were assessed using the PSPRS and executive function was tested with phonemic and semantic verbal fluency tasks. Spatio-temporal gait characteristics and gait variability were measured during a two-minute walk task using body-worn sensors. Correlation analysis tested associations between fluency and PSRPS, group analysis compared gait performance between fluency levels, and a two-way ANOVA assessed longitudinal effects.

Results: At baseline, higher semantic fluency was distinctly linked with lower symptom severity on the PSPRS, lesser gait speed variability, and lesser stride length variability. The association between semantic fluency and gait speed variability was confirmed by the longitudinal analysis.

Conclusion: Executive function and gait variability are associated in PSP, and this link persists over time. Higher semantic fluency is linked with reduced gait variability (i.e., more controlled movements), potentially to minimize fall risk. Our findings highlight the clinical importance of executive function for gait stability, emphasizing its role in PSP assessment and interventions.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/gait-variability-is-associated-with-executive-function-in-progressive-supranuclear-palsy/