Deficits in visuospatial processing contribute to quantitative measures of freezing of gait in Parkinson’s disease

Nantel, Julie; McDonald, Jaime; Tan, Simon; Brontë‐Stewart, Helen

doi:10.1016/j.neuroscience.2012.07.007

Cited by 99 publications

(75 citation statements)

References 26 publications

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“…In the current study, deficits in executive (processing speed) and visuospatial functions were associated with more severe freezing of gait. This finding is consistent with research showing greater deficits in executive function [23] and visuospatial function [24] in people with PD who have freezing of gait compared to those without freezing, and suggests involvement of premotor and parietal areas could contribute to freezing [25]. Finally, deficits in executive function (processing speed) and memory were specifically associated with more significant postural instability, which contrasts with previous research demonstrating associations between postural instability in the off-medication state and phonemic fluency [18].…”

Section: Discussionsupporting

confidence: 92%

Association of cognitive domains with postural instability/gait disturbance in Parkinson's disease

Kelly

Johnson

McGough

et al. 2015

Parkinsonism & Related Disorders

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Introduction Research suggests an association between global cognition and postural instability/gait disturbance (PIGD) in Parkinson’s disease (PD), but the relationship between specific cognitive domains and PIGD symptoms is not clear. This study examined the association of cognition (global and specific cognitive domains) with PIGD symptoms in a large, well-characterized sample of individuals with PD. Methods Cognitive function was measured with a detailed neuropsychological assessment, including global cognition, executive function, memory, visuospatial function, and language. PIGD symptoms were measured using the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III, Motor Examination subscale. Multiple linear regression analyses were performed to assess the relationship between cognition and PIGD symptoms with models adjusting for age, sex, education, enrollment site, disease duration, and motor symptom severity. Results The analysis included 783 participants, with mean (standard deviation) age of 67.3 (9.7) years and median (interquartile range) MDS-UPDRS Motor Subscale score of 26 (17, 35). Deficits in global cognition, executive function, memory, and phonemic fluency were associated with more severe PIGD symptoms. Deficits in executive function were associated with impairments in gait, freezing, and postural stability, while visuospatial impairments were associated only with more severe freezing, and poorer memory function was associated only with greater postural instability. Discussion While impairments in global cognition and aspects of executive functioning were associated with more severe PIGD symptoms, specific cognitive domains were differentially related to distinct PIGD components, suggesting the presence of multiple neural pathways contributing to associations between cognition and PIGD symptoms in persons with PD.

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Section: Discussionsupporting

confidence: 92%

Association of cognitive domains with postural instability/gait disturbance in Parkinson's disease

Kelly

Johnson

McGough

et al. 2015

Parkinsonism & Related Disorders

View full text Add to dashboard Cite

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“…Less segregation in these areas at rest suggests impaired visuomotor information processing at baseline that might contribute to difficulties with task-set maintenance. This finding is consistent with visuomotor processing problems in PD causing difficulties with judging distances and motion, and navigating around obstacles in everyday environments (Davidsdottir et al 2005), as well as freezing of gait (Fahn 1995; Cowie et al 2012; Nantel et al 2012). Further evidence for abnormal visuomotor processing comes from a task-based fMRI study.…”

Section: Discussionsupporting

confidence: 75%

Deficits in task-set maintenance and execution networks in Parkinson’s disease

et al. 2015

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Patients with Parkinson’s disease have difficulties with self-initiating a task and maintaining a steady task performance. We hypothesized that these difficulties relate to reorganization in the sensorimotor execution, cingulo-opercular task-set maintenance, and frontoparietal adaptive control networks. We tested this hypothesis using graph theory-based network analysis of a composite network including a total of 86 nodes, derived from the three networks of interest. Resting-state functional magnetic resonance images were collected from 30 patients with Parkinson’s disease (age 42–75 years, 11 females; Hoehn and Yahr score 2–3, average 2.4 ± 0.4) in their off-medication state and 30 matched control subjects (age 44–75 years, 10 females). For each node, we calculated strength as a general measure of connectivity, global efficiency and betweenness centrality as measures of functional integration, and clustering coefficient and local efficiency as measures of functional segregation. We found reduced node strength, clustering, and local efficiency in sensorimotor and posterior temporal nodes. There was also reduced node strength and betweenness centrality in the dorsal anterior insula and temporoparietal junction nodes of the cingulo-opercular network. These nodes are involved in integrating multimodal information, specifically related to self-awareness, sense of agency, and ultimately to intact perception of self-in-action. Moreover, we observed significant correlations between global disease severity and averaged graph metrics of the whole network. In addition to the well-known task-related frontostriatal mechanisms, we propose that the resting-state reorganization in the composite network can contribute to problems with self-initiation and task-set maintenance in Parkinson’s disease.

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“…The absence of a correlation between FOG and the WAIS block design task did not provide support for a relation between FOG and right-hemisphere dysfunction in PD, although such correlation has previously been reported [103]. The low number of PD_FOG patients may be due to this negative result.…”

Section: Discussioncontrasting

confidence: 67%

Parkinson-Related Changes of Activation in Visuomotor Brain Regions during Perceived Forward Self-Motion

et al. 2014

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Radial expanding optic flow is a visual consequence of forward locomotion. Presented on screen, it generates illusionary forward self-motion, pointing at a close vision-gait interrelation. As particularly parkinsonian gait is vulnerable to external stimuli, effects of optic flow on motor-related cerebral circuitry were explored with functional magnetic resonance imaging in healthy controls (HC) and patients with Parkinson’s disease (PD). Fifteen HC and 22 PD patients, of which 7 experienced freezing of gait (FOG), watched wide-field flow, interruptions by narrowing or deceleration and equivalent control conditions with static dots. Statistical parametric mapping revealed that wide-field flow interruption evoked activation of the (pre-)supplementary motor area (SMA) in HC, which was decreased in PD. During wide-field flow, dorsal occipito-parietal activations were reduced in PD relative to HC, with stronger functional connectivity between right visual motion area V5, pre-SMA and cerebellum (in PD without FOG). Non-specific ‘changes’ in stimulus patterns activated dorsolateral fronto-parietal regions and the fusiform gyrus. This attention-associated network was stronger activated in HC than in PD. PD patients thus appeared compromised in recruiting medial frontal regions facilitating internally generated virtual locomotion when visual motion support falls away. Reduced dorsal visual and parietal activations during wide-field optic flow in PD were explained by impaired feedforward visual and visuomotor processing within a magnocellular (visual motion) functional chain. Compensation of impaired feedforward processing by distant fronto-cerebellar circuitry in PD is consistent with motor responses to visual motion stimuli being either too strong or too weak. The ‘change’-related activations pointed at covert (stimulus-driven) attention.

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Deficits in visuospatial processing contribute to quantitative measures of freezing of gait in Parkinson’s disease

Cited by 99 publications

References 26 publications

Association of cognitive domains with postural instability/gait disturbance in Parkinson's disease

Association of cognitive domains with postural instability/gait disturbance in Parkinson's disease

Deficits in task-set maintenance and execution networks in Parkinson’s disease

Parkinson-Related Changes of Activation in Visuomotor Brain Regions during Perceived Forward Self-Motion

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