Is Cortical Activation during Walking Different between Parkinson's Disease Motor Subtypes?

Parkinson's disease (PD) is often classified into tremor dominant (TD) and postural instability gait disorder (PIGD) subtypes. Degeneration of subcortical/cortical pathways is different betweenPD subtypes, which leads to differences in motor behavior. However, the influence of PD subtype on cor...

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Bibliographic Details
Authors: Orcioli-Silva, Diego [UNESP], Vitório, Rodrigo [UNESP], Beretta, Victor Spiandor [UNESP], Da Conceição, Núbia Ribeiro [UNESP], Nóbrega-Sousa, Priscila [UNESP], Oliveira, Anderson Souza [UNESP], Gobbi, Lilian Teresa Bucken [UNESP]
Format: article
Status:Published version
Publication Date:2021
Country:Brasil
Institution:Universidade Estadual Paulista (UNESP)
Repository:Repositório Institucional da UNESP
Language:English
OAI Identifier:oai:repositorio.unesp.br:11449/208565
Online Access:http://dx.doi.org/10.1093/gerona/glaa174
http://hdl.handle.net/11449/208565
Access Level:Open access
Keyword:EEG
fNIRS
Gait
PIGD
Tremor dominant
Description
Summary:Parkinson's disease (PD) is often classified into tremor dominant (TD) and postural instability gait disorder (PIGD) subtypes. Degeneration of subcortical/cortical pathways is different betweenPD subtypes, which leads to differences in motor behavior. However, the influence of PD subtype on cortical activity during walking remains poorly understood. Therefore, we aimed to investigate the influence of PD motor subtypes on cortical activity during unobstructed walking and obstacle avoidance. Seventeen PIGD and 19 TD patients performed unobstructed walking and obstacle avoidance conditions. Brain activity was measured using a mobile functional near-infrared spectroscopy-electroencephalography (EEG) systems, and gait parameters were analyzed using an electronic carpet. Concentrations of oxygenated hemoglobin (HbO2) of the prefrontal cortex (PFC) and EEG absolute power from alpha, beta, and gamma bands in FCz, Cz, CPz, and Oz channels were calculated. These EEG channels correspond to supplementary motor area, primary motor cortex, posterior parietal cortex, and visual cortex, respectively. Postural instability gait disorder patients presented higher PFC activity than TD patients, regardless of the walking condition. Tremor dominant patients presented reduced beta power in the Cz channel during obstacle avoidance compared to unobstructed walking. Both TDand PIGD patients decreased alpha and beta power in the FCz and CPz channels. In conclusion, PIGD patients need to recruit additional cognitive resources from the PFC for walking. Both TD and PIGD patients presented changes in the activation of brain areas related to motor/sensorimotor areas in order to maintain balance control during obstacle avoidance, being that TD patients presented further changes in the motor area (Cz channel) to avoid obstacles.