Visuomotor control of walking in Parkinson's disease: Exploring possible links between conscious movement processing and freezing of gait.

Autor: Hardeman LES; Faculty of Behavioral and Movement Sciences, VU University Amsterdam, Netherlands; College of Health, Medicine and Life Sciences, Brunel University London, UK., Kal EC; College of Health, Medicine and Life Sciences, Brunel University London, UK; Centre for Cognitive Neuroscience, Brunel University London, UK., Young WR; College of Health, Medicine and Life Sciences, Brunel University London, UK; School of Sport and Health Sciences, University of Exeter, UK., van der Kamp J; Faculty of Behavioral and Movement Sciences, VU University Amsterdam, Netherlands., Ellmers TJ; College of Health, Medicine and Life Sciences, Brunel University London, UK; Centre for Cognitive Neuroscience, Brunel University London, UK. Electronic address: toby.ellmers@brunel.ac.uk.
Jazyk: angličtina
Zdroj: Behavioural brain research [Behav Brain Res] 2020 Oct 01; Vol. 395, pp. 112837. Date of Electronic Publication: 2020 Jul 31.
DOI: 10.1016/j.bbr.2020.112837
Abstrakt: Introduction: Changes in visual attention have been argued to influence freezing of gait (FOG) in people with Parkinson's Disease (PD). However, the specific visual search patterns of people with FOG pathology (PD + FOG) and potential underlying mechanisms are not well understood. The current study explored visual search behavior in PD + FOG while walking on a pathway featuring environmental features known to exacerbate FOG (e.g., narrow doorway and tripping hazards). Potential underpinning attentional mechanisms were also assessed, such as conscious movement processing.
Methods: Visual search behavior of twelve people with PD + FOG tested in ON-state (M age = 74.3) and twelve age-matched healthy controls (M age = 72.5) were analyzed during a complex walking task. The task required participants to step over an obstacle and navigate through a narrow doorway, surrounded by clutter.
Results: People with PD + FOG more frequently directed visual attention to ongoing and imminent steps compared to healthy controls (Mdn = 26% vs Mdn = 14%, respectively; p = 0.042). Self-reported conscious movement processing was also significantly higher in people with PD + FOG. The one participant who froze during the walking task fixated the future trip hazard (obstacle, approximately 6 steps ahead) almost exclusively during freezing trials (i.e., 60-100% of the trial). In contrast, during 'non-freeze' trials, this participant increased the duration of fixations towards ongoing and imminent steps.
Conclusion: Results suggest that people with PD + FOG strongly monitor/control ongoing and immediately upcoming stepping movements. However, prolonged fixations towards threats to future movements might prevent people with PD + FOG from processing the visual information needed to do this, thereby provoke freezing episodes.
(Copyright © 2020. Published by Elsevier B.V.)
Databáze: MEDLINE
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