Recovery from Multiple APAs Delays Gait Initiation in Parkinson’s Disease
| Autor: | John G. Nutt, Fay B. Horak, Rajal G. Cohen |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Parkinson's disease education gait initiation freezing of gait 03 medical and health sciences Behavioral Neuroscience 0302 clinical medicine Physical medicine and rehabilitation mental disorders Inhibitory control Healthy control medicine anticipatory postural adjustment Gait initiation Latency (engineering) Biological Psychiatry Original Research medicine.disease Gait inhibition start hesitation inhibitory control Psychiatry and Mental health 030104 developmental biology Neuropsychology and Physiological Psychology Neurology Parkinson’s disease Physical therapy Psychology voluntary stepping psychological phenomena and processes 030217 neurology & neurosurgery Neuroscience Stroop effect |
| Zdroj: | Frontiers in Human Neuroscience |
| ISSN: | 1662-5161 |
| DOI: | 10.3389/fnhum.2017.00060 |
| Popis: | Background: Freezing of gait in Parkinson’s disease (PD) has been linked with deficits in inhibitory control, but causal mechanisms are not established. Freezing at gait initiation (start hesitation) is often accompanied by multiple anticipatory postural adjustments (APAs). If inhibition deficits contribute to freezing by interfering with ability to inhibit initial weight shifts in the wrong direction, then PD subjects should experience more episodes of multiple APAs than healthy controls (HCs) do. If inhibition deficits contribute to freezing by interfering with ability to release a previously inhibited step following multiple APAs, then step onset following multiple APAs should be delayed more in people with PD than in HCs. Methods: Older adults with PD and HC subjects rapidly initiated stepping in response to a light cue in blocks of simple (SRT) and choice (CRT) conditions. We recorded kinematics and ground reaction forces, and we administered the Stroop task to assess inhibitory control. Results: Multiple APAs were more common in CRT than SRT conditions but were equally common in HC and PD subjects. Step onsets were delayed in both conditions and further delayed in trials with multiple APAs, except for HC subjects in SRT trials. Poor Stroop performance correlated with many multiple APAs, late step onset, and rearward position of center of mass (COM) at cue presentation. Forward motion of the COM during the APA was higher in trials with multiple APAs than in trials with single APAs, especially in CRT trials and in PD subjects without self-reported freezing. Conclusion: Start hesitation is not caused by multiple APAs per se, but may be associated with difficulty recovering from multiple APAs, due to difficulty releasing a previously inhibited step. |
| Databáze: | OpenAIRE |
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