Objective: This study aimed to; 1) examine pre-frontal cortex (PFC) activation during walking in response to increased attentional load (dual-task) in Parkinson’s disease (PD); and 2) explore the relationship between attention and PFC activation during walking in PD.

Background: Gait impairment is a core feature of PD, with links to falls risk. Attention may be an important contributor to gait in PD, with associative and dual-task studies highlighting a strong association between them [1]. Attentional projections stem from the PFC, and may become over-active during gait in PD compared to healthy controls, to compensate for the impaired basal ganglia output that affects the automaticity of movement. Recent technological advancement has allowed monitoring of PFC activity during actual motor tasks, using methods such as mobile functional near infrared spectroscopy (fNIRS) [2]. Monitoring PFC activity during gait may provide understanding of the underlying mechanisms involved in gait impairment, which would inform development of tailored interventions.

Method: Nine people with PD (Age; 71.7±6.4, MoCA; 26.9±1.8; UPDRS-III; 43.2±10.3, OFF medication) walked under single and dual-task (AX-CPT) over-ground for two minutes back and forth over 10m, with a 20 second stand at the beginning and at the end of the walk. PFC activity was recorded via a mobile fNIRS device; 6 emitter-detector pairs with 2 reference channels to remove peripheral signal noise. Attention was examined using a computerized battery [3]. The primary outcome was relative change (∆) in HbO2 from baseline (standing) with walking, which is a proxy for PFC activation.

Results: Interestingly, preliminary results indicated that there was no significant difference in PFC activation between single (∆HbO2=-0.04±0.17) and dual-task (∆HbO2=-0.08±0.42) walking in PD (Z=-0.30, p=.767). However, there was a significant relationship between better attention and greater PFC activation during single-task walking (rho=-73, p=.025), but not during dual-task conditions.

Conclusion: These preliminary findings suggest that attentional capabilities may underpin PFC activity during walking in PD. In future, this study will analyze the same outcome measures in a larger cohort.

References: [1] Morris, R. et al. (2016). Neurosci Biobehav Rev [2] Stuart, S. et al. (2018). Maturitas [3] Elder, G. et al. (2016). Int Psychoger

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MDS Abstracts - https://www.mdsabstracts.org/abstract/pre-frontal-activation-during-walking-in-parkinsons-disease-the-impact-of-attention/