Lateralized cognitive functions in Parkinson’s patients: A behavioral approach for the early detection of sustained attention deficits

Agosta, Sara; Magnago, Denise; Galante, Emanuela; Ferraro, Francesco; Magherini, Anna; Giacopo, Raffaella Di; Miceli, Gabriele; Battelli, Lorella

doi:10.1016/j.brainres.2019.146486

Cited by 11 publications

(5 citation statements)

References 52 publications

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“…Referring to these mechanisms, we can point to two main insights gained from our results. First, the reduction in BEI signals during the cognitive movement strategy may represent the intersection between limited ability to sustain attention in PwP ( Zgaljardic et al, 2003 ; Agosta et al, 2020 ) and higher demands for attention imposed by the cognitive movement strategy. This intersection is less robust in the MET condition, as its attentional demands may be lower.…”

Section: Discussionmentioning

confidence: 99%

“…Deficits in divided attention are extensively reported in the context of the dual-task paradigm in walking, as are their negative consequences for walking and risk of falling in PwP ( Yogev-seligmann et al, 2008 ). Sustained attention was also reported to be impaired in PwP ( Lord et al, 2010 ; Pfeiffer et al, 2014 ; Agosta et al, 2020 ), and this impairment was demonstrated to be associated with decrements in gait speed ( Lord et al, 2010 ). However, despite the common recommendation for compensatory gait strategies (e.g., cognitive movement, external cueing) and the documented cognitive deficits of PwP, the attentional load of using these strategies and its association with cognitive function in PwP was not directly measured in real-life circumstances.…”

Section: Introductionmentioning

confidence: 99%

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Compensatory movement strategies differentially affect attention allocation and gait parameters in persons with Parkinson’s disease

Yogev‐Seligmann

Krasovsky

Kafri

2022

Front. Hum. Neurosci.

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Persons with Parkinson’s disease (PwP) are advised to use compensatory strategies such as external cues or cognitive movement strategies to overcome gait disturbances. It is suggested that external cues involve the processing of sensory stimulation, while cognitive-movement strategies use attention allocation. This study aimed to compare over time changes in attention allocation in PwP between prolonged walking with cognitive movement strategy and external cues; to compare the effect of cognitive movement strategies and external cues on gait parameters; and evaluate whether these changes depend on cognitive function. Eleven PwP participated in a single-group pilot study. Participants walked for 10 min under each of three conditions: natural walking, using external cuing, using a cognitive movement strategy. Attention and gait variables were extracted from a single-channel electroencephalogram and accelerometers recordings, respectively. Attention allocation was assessed by the% of Brain Engagement Index (BEI) signals within an attentive engagement range. Cognitive function was assessed using a neuropsychological battery. The walk was divided into 2-min time segments, and the results from each 2-min segment were used to determine the effects of time and condition. Associations between cognitive function and BEI signals were tested. Findings show that in the cognitive movement strategy condition, there was a reduction in the % of BEI signals within the attentive engagement range after the first 2 min of walking. Despite this reduction the BEI did not consistently differ from natural and metronome walking. Spatiotemporal gait variables were better in the cognitive movement strategy condition relative to the other conditions. Global cognitive and information processing scores were significantly associated with the BEI only when the cognitive movement strategy was applied. In conclusion, the study shows that a cognitive movement strategy has positive effects on gait variables but may impose a higher attentional load. Furthermore, when walking using a cognitive movement strategy, persons with higher cognitive function showed elevated attentive engagement. The findings support the idea that cognitive and attentional resources are required for cognitive movement strategies in PwP. Additionally, this study provides support for using single-channel EEG to explore mechanistic aspects of clinical interventions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Compensatory movement strategies differentially affect attention allocation and gait parameters in persons with Parkinson’s disease

Yogev‐Seligmann

Krasovsky

Kafri

2022

Front. Hum. Neurosci.

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“…In accordance with the SOC model, the skin responses and olfaction were deficient ipsilateral to the most diseased hemisphere. A number of studies have compared cognitive deficit in the visual-spatial domain of left-sided vs. right-sided hemiparkinsonian PD patients, including optic flow, mental rotation, facial emotion recognition, hierarchical pattern recognition, sustained attention, and complex figure copying [94][95][96][97][98][99]. Patients with leftsided hemiparkinsonism were more impaired in tasks involving their left visual hemifield, whereas patients with right-sided hemiparkinsonism showed impairment in their right visual hemifield.…”

Section: Other Asymmetriesmentioning

confidence: 99%

The α-Synuclein Origin and Connectome Model (SOC Model) of Parkinson’s Disease: Explaining Motor Asymmetry, Non-Motor Phenotypes, and Cognitive Decline

Borghammer

2021

JPD

145

111

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A new model of Parkinson’s disease (PD) pathogenesis is proposed, the α-Synuclein Origin site and Connectome (SOC) model, incorporating two aspects of α-synuclein pathobiology that impact the disease course for each patient: the anatomical location of the initial α-synuclein inclusion, and α-synuclein propagation dependent on the ipsilateral connections that dominate connectivity of the human brain. In some patients, initial α-synuclein pathology occurs within the CNS, leading to a brain-first subtype of PD. In others, pathology begins in the peripheral autonomic nervous system, leading to a body-first subtype. In brain-first cases, it is proposed that the first pathology appears unilaterally, often in the amygdala. If α-synuclein propagation depends on connection strength, a unilateral focus of pathology will disseminate more to the ipsilateral hemisphere. Thus, α-synuclein spreads mainly to ipsilateral structures including the substantia nigra. The asymmetric distribution of pathology leads to asymmetric dopaminergic degeneration and motor asymmetry. In body-first cases, the α-synuclein pathology ascends via the vagus to both the left and right dorsal motor nuclei of the vagus owing to the overlapping parasympathetic innervation of the gut. Consequently, the initial α-synuclein pathology inside the CNS is more symmetric, which promotes more symmetric propagation in the brainstem, leading to more symmetric dopaminergic degeneration and less motor asymmetry. At diagnosis, body-first patients already have a larger, more symmetric burden of α-synuclein pathology, which in turn promotes faster disease progression and accelerated cognitive decline. The SOC model is supported by a considerable body of existing evidence and may have improved explanatory power.

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“…Thus, persons with PD may tax their executive and attentional processes for all types of tasks, even automatic or routine tasks such as walking and talking [20]. Internal control of attention may also be impaired Dujardin, et al, including tasks requiring sustained and alternating attention [21,22]. Disruption to attention neural network connectivity, and the associated behavioral manifestations, may be prominent even in mild cognitive impairment from PD [23].…”

Section: Summary Of Vulnerable Cognitive Domains In Pdmentioning

confidence: 99%

Untitled

2022

Int J Neurodegener Dis

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Purpose: Cognitive changes in Parkinson's disease (PD) can occur at any stage of the disease and have been shown to significantly impact well-being and life participation. The nature and pattern of cognitive decline in PD remains unclear due to the heterogeneity of symptoms and lack of a clear explanatory model. This review aims to draw attention to several theoretical models of cognitive decline in PD to deepen our understanding of the complex milieu of symptoms and begin to offer clinical implications for rehabilitation fields. Method:The domains of cognition typically affected by PD are reviewed along with key aspects of five prominent models of cognition in PD. Implications are discussed through the lens of cognitive heterogeneity and clinical practice.Results: Multiple cognitive domains are vulnerable to PD neuropathology, however, variability exists in the presence and severity of functional changes. Theoretical models that highlight disease progression, vulnerable neural networks, and neurotransmitter involvement provide insight into the variability of cognitive changes. Conclusion:Although one single model cannot account for the wide variability in presentation and rate of cognitive decline in PD, consideration of multiple models provides important insight for research and clinical practice, such as the delineation of cognitive phenotypes.

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Lateralized cognitive functions in Parkinson’s patients: A behavioral approach for the early detection of sustained attention deficits

Cited by 11 publications

References 52 publications

Compensatory movement strategies differentially affect attention allocation and gait parameters in persons with Parkinson’s disease

Compensatory movement strategies differentially affect attention allocation and gait parameters in persons with Parkinson’s disease

The α-Synuclein Origin and Connectome Model (SOC Model) of Parkinson’s Disease: Explaining Motor Asymmetry, Non-Motor Phenotypes, and Cognitive Decline

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