Objective: To assess cognitive-motor interference (CMI) and task prioritization during simultaneous performance of a cognitive task and an upper extremity motor task in Parkinson’s disease (PD).

Background: PD patients may experience reduced motor and/or cognitive function when under simultaneous loading (double task, e.g., “stop walking when talking”). Clinical tests, however, mostly evaluate function of the cognitive and motor systems in isolation or involve a qualitative assessment of CMI without addressing task prioritization.

Methods: 32 PD patients (21 male; age 64±9 years; H&Y stadia 1-5) performed a cognitive auditory Stroop task and a visuo-motor task, collecting target objects and avoiding obstacles in a virtual environment by means of flexion and extension movements of the wrist in a one degree-of-freedom haptic robot. Both tasks were performed separately (single task condition) as well as simultaneously (dual task condition). For each task, CMI was calculated as the difference in performance between these two conditions (expressed as a percentage of single task performance to allow for comparison between the cognitive and motor task). Partial correlation was used to evaluate whether single task performance, CMI, and task prioritization were related to clinical measures of cognitive function (SCOPA-COG; corrected for MDS-UPDRS-III) and motor function (MDS-UPDRS-III; corrected for SCOPA-COG).

Results: When tasks were performed simultaneously, cognitive performance deteriorated more than motor performance, indicating that the motor task was prioritized. Reduced performance on the SCOPA-COG was associated with a reduced cognitive and motor performance in the single task condition (r=.51, p=.004 and r=.57, p=.001), large CMI for the cognitive task (r=-.58, p=.001), and prioritization of the motor task (r=-.47, p=.008). Findings were not significantly correlated to MDS-UPDRS-III scores.

Conclusions: Our results suggest that CMI during upper extremity motor performance in PD patients is mainly reflected in reduction of cognitive task performance, and that this CMI is primarily determined by cognitive function. Systematic assessment of CMI seems to provide added value to the separate assessment of cognitive and motor function, but it remains to be investigated how findings relate to problems in daily life.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/assessment-of-cognitive-motor-interference-during-an-upper-extremity-motor-task-in-parkinsons-disease/