Cognitive predictors of balance in Parkinson’s disease

Abstract

Postural instability is one of the most incapacitating symptoms of Parkinson's disease (PD) and appears to be related to cognitive deficits. This study aims to determine the cognitive factors that can predict deficits in static and dynamic balance in individuals with PD. A sociodemographic questionnaire characterized 52 individuals with PD for this work. The Trail Making Test, Rule Shift Cards Test, and Digit Span Test assessed the executive functions. The static balance was assessed using a plantar pressure platform, and dynamic balance was based on the Timed Up and Go Test. The results were statistically analysed using SPSS Statistics software through linear regression analysis. The results show that a statistically significant model based on cognitive outcomes was able to explain the variance of motor variables. Also, the explanatory value of the model tended to increase with the addition of individual and clinical variables, although the resulting model was not statistically significant The model explained 25-29% of the variability of the Timed Up and Go Test, while for the anteroposterior displacement it was 23-34%, and for the mediolateral displacement it was 24-39%. From the findings, we conclude that the cognitive performance, especially the executive functions, is a predictor of balance deficit in individuals with PD. ARTICLE HISTORY

Is virtual reality beneficial for dual-task gait training in patients with Parkinson's disease? A systematic review

“…VR dual-task gait training involves executive function,19 a predictor of balance deficits in patients with PD 48. VR tasks involve gait control and meet environmental demands (e.g.…”

Data_Sheet_1.pdf

“…In addition, we examined the effect of cognitive function in postural control via the DCCS task and found that PDPI+ participants performed the task poorly, compared to PDPI− and controls. Similar to our results, previous reports have shown a reduction in cognitive function in PD patients with abnormal balance and postural control (48,49), suggesting a dysfunction of common neural networks in PDPI+. Furthermore, this relationship is supported by previous studies' results with lower theta activity in the frontal region at the occurrence of target stimuli during a cognitive task (24,26,50).…”

Phenotype of postural instability/gait difficulty in Parkinson disease: relevance to cognitive impairment and mechanism relating pathological proteins and neurotransmitters

“…A previous study showed that more cognition-related regions, such as caudate, fusiform gyrus and inferior parietal lobes35, were affected in PIGD patients. One study reported that cognitive performance was a predictor of postural control in individuals with PD36. PD patients could increase attention to counteract the balance disturbance in late stage37, therefore, PD patients exhibited more impaired postural control in the cognitive-motor dual-task condition in later stage because of distraction by cognitive task.…”