The plurality of mechanisms of gait initiation disorders in Parkinson's disease: Relationships with motor, cognitive and limbic functions.
Executive control
Freezing of gait (FoG)
Gait initiation
Parkinson’s disease (PD)
Journal
Gait & posture
ISSN: 1879-2219
Titre abrégé: Gait Posture
Pays: England
ID NLM: 9416830
Informations de publication
Date de publication:
26 Jul 2024
26 Jul 2024
Historique:
received:
08
12
2022
revised:
25
07
2024
accepted:
26
07
2024
medline:
2
8
2024
pubmed:
2
8
2024
entrez:
1
8
2024
Statut:
aheadofprint
Résumé
Deficient postural adaptation and freezing lead to gait initiation abnormalities in Parkinson's disease. Gait initiation is characterized by longer motor preparation, which is a marker of increased risk of falling, and by abnormal postural adjustments. Better understanding the nature of these motor preparation disturbances will enable us to adapt rehabilitation and reduce falls. Our objective was to describe the different components (in the motor, cognitive and limbic domains) of gait initiation parameters in Parkinson's disease. Forty-four patients with Parkinson's disease performed repeated step initiations under high attentional load with decision-making. The proportions of multiple anticipatory postural adjustments and anticipatory postural adjustment errors, markers of abnormal motor preparation, were measured. A logistic regression analysis studied the relationships between step initiation perturbations and the demographic, motor, cognitive, and neuropsychiatric characteristics of the patients. Multiple anticipatory postural adjustments and anticipatory postural adjustments errors lengthened step execution time. Motor severity explained the multiple anticipatory postural adjustments, suggesting a pathological role. Attentional performance explained anticipatory postural adjustments errors. Demographic and neuropsychiatric characteristics didn't contribute significantly to the abnormal anticipatory postural adjustments. Motor disability contributes to the delay in step execution in Parkinson's disease through multiple anticipatory postural adjustments, highlighting the need to target motor preparation improvement in rehabilitation.
Sections du résumé
BACKGROUND
BACKGROUND
Deficient postural adaptation and freezing lead to gait initiation abnormalities in Parkinson's disease. Gait initiation is characterized by longer motor preparation, which is a marker of increased risk of falling, and by abnormal postural adjustments. Better understanding the nature of these motor preparation disturbances will enable us to adapt rehabilitation and reduce falls.
RESEARCH QUESTION
OBJECTIVE
Our objective was to describe the different components (in the motor, cognitive and limbic domains) of gait initiation parameters in Parkinson's disease.
METHODS
METHODS
Forty-four patients with Parkinson's disease performed repeated step initiations under high attentional load with decision-making. The proportions of multiple anticipatory postural adjustments and anticipatory postural adjustment errors, markers of abnormal motor preparation, were measured. A logistic regression analysis studied the relationships between step initiation perturbations and the demographic, motor, cognitive, and neuropsychiatric characteristics of the patients.
RESULTS
RESULTS
Multiple anticipatory postural adjustments and anticipatory postural adjustments errors lengthened step execution time. Motor severity explained the multiple anticipatory postural adjustments, suggesting a pathological role. Attentional performance explained anticipatory postural adjustments errors. Demographic and neuropsychiatric characteristics didn't contribute significantly to the abnormal anticipatory postural adjustments.
SIGNIFICANCE
CONCLUSIONS
Motor disability contributes to the delay in step execution in Parkinson's disease through multiple anticipatory postural adjustments, highlighting the need to target motor preparation improvement in rehabilitation.
Identifiants
pubmed: 39088931
pii: S0966-6362(24)00508-3
doi: 10.1016/j.gaitpost.2024.07.296
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
407-411Informations de copyright
Copyright © 2024 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest All authors declare no Conflict of Interest. There's no financial/personal interest or belief that could affect our objectivity, or if there is, stating the source and nature of that potential conflict. No potential competing interests exist.