Neural Control of Walking in People with Parkinsonism

Peterson, Daniel S.; Horak, Fay B.

doi:10.1152/physiol.00034.2015

Cited by 134 publications

(131 citation statements)

References 157 publications

Supporting

Mentioning

118

Contrasting

Unclassified

Order By: Relevance

“…Gait variability can occur in both the medio‐lateral and anterior–posterior planes, which may reflect distinct mechanisms . Although dual‐task paradigms are known to provoke greater gait variability in both planes, especially in patients with PD or dementia, the current study did not find differences between iRBD and HC participants in step length variability (ie, iRBD patients increased their step length variability in a similar manner as HC participants as the dual‐task challenge increased).…”

Section: Discussioncontrasting

confidence: 65%

“…Step width variability, although belonging to the variability domain of gait, has been thought to relate to active step‐to‐step adjustment by the central nervous system to maintain balance during gait . Elevated lateral step variability is commonly observed in early PD and has been suggested to reflect impaired control of lateral postural equilibrium . Taken together, these findings suggest that postural stability during walking is disproportionately affected by dual tasking in iRBD patients, mirroring what is seen in early PD, and may therefore reflect shared neuropathological underpinnings.…”

Section: Discussionmentioning

confidence: 92%

See 1 more Smart Citation

Subtle gait and balance impairments occur in idiopathic rapid eye movement sleep behavior disorder

et al. 2019

View full text Add to dashboard Cite

Background Although motor abnormalities have been flagged as potentially the most sensitive and specific clinical features for predicting the future progression to Parkinson's disease, little work has been done to characterize gait and balance impairments in idiopathic rapid eye movement sleep behavior disorder (iRBD). Objective The objective of this study was to quantitatively determine any static balance as well as gait impairments across the 5 independent domains of gait in polysomnography‐confirmed iRBD patients using normal, fast‐paced, and dual‐task walking conditions. Methods A total of 38 participants (24 iRBD, 14 healthy controls) completed the following 5 different walking trials across a pressure sensor carpet: (1) normal pace, (2) fast pace, (3) while counting backward from 100 by 1s, (4) while naming as many animals as possible, (5) while subtracting 7s from 100. Results Although no gait differences were found between the groups during normal walking, there were significant differences between groups under the fast‐paced and dual‐task gait conditions. Specifically, in response to the dual tasking, healthy controls widened their step width without changing step width variability, whereas iRBD patients did not widen their step width but, rather, significantly increased their step width variability. Similarly, changes between the groups were observed during fast‐paced walking wherein the iRBD patients demonstrated greater step length asymmetry when compared with controls. Conclusions This study demonstrates that iRBD patients have subtle gait impairments, which likely reflect early progressive degeneration in brainstem regions that regulate both REM sleep and gait coordination. Such gait assessments may be useful as a diagnostic preclinical screening tool for future fulminant gait abnormalities for trials of disease‐preventive agents. © 2019 International Parkinson and Movement Disorder Society

show abstract

Section: Discussioncontrasting

confidence: 65%

Section: Discussionmentioning

confidence: 92%

Subtle gait and balance impairments occur in idiopathic rapid eye movement sleep behavior disorder

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The model indicates that subcortical locomotor dysfunction causes both decreased walking capacity and a compensatory increase in conscious cortical input to the subcortical locomotor network. (Peterson and Horak, 2016) This compensation is thought to be the mechanism of increased gait variability and decreased automaticity in Parkinson’s Disease. (Peterson and Horak, 2016) Our gait association findings suggest that greater CLR-M1F connectivity could represent this compensatory increase in conscious locomotor control.…”

Section: Discussionmentioning

confidence: 99%

Resting‐state functional connectivity of subcortical locomotor centers explains variance in walking capacity

Boyne

Maloney

DiFrancesco

et al. 2018

Human Brain Mapping

View full text Add to dashboard Cite

Walking capacity influences the quality of life and disability in normal aging and neurological disease, but the neural correlates remain unclear and subcortical locomotor regions identified in animals have been more challenging to assess in humans. Here we test whether resting-state functional MRI connectivity (rsFC) of midbrain and cerebellar locomotor regions (MLR and CLR) is associated with walking capacity among healthy adults. Using phenotypic and MRI data from the Nathan Kline Institute Rockland Sample (n =119, age 18-85), the association between walking capacity (6-min walk test distance) and rsFC was calculated from subcortical locomotor regions to 81 other gait-related regions of interest across the brain. Additional analyses assessed the independence and specificity of the results. Walking capacity was associated with higher rsFC between the MLR and superior frontal gyrus adjacent to the anterior cingulate cortex, higher rsFC between the MLR and paravermal cerebellum, and lower rsFC between the CLR and primary motor cortex foot area. These rsFC correlates were more strongly associated with walking capacity than phenotypic variables such as age, and together explained 25% of the variance in walking capacity. Results were specific to locomotor regions compared with the other brain regions. The rsFC of locomotor centers correlates with walking capacity among healthy adults. These locomotion-related biomarkers may prove useful in future work aimed at helping patients with reduced walking capacity.

show abstract

“…A recent gait model, validated on a PD population, found five independent domains to represent the overarching construct of gait—Pace; Rhythm; Variability; Asymmetry; and Postural control (Lord, Galna, & Rochester, 2013). Whereas the PD‐specific symptoms, bradykinesia and rigidity, contribute to disturbances in the Pace and Rhythm, the unilateral debut of these symptoms manifests as increased gait Asymmetry (Lord, Galna, Verghese et al., 2013; Peterson & Horak, 2016). Gait Variability increases in line with disease progression and may have the potential to predict falls in PD (Hausdorff, 2005, 2007).…”

Section: Introductionmentioning

confidence: 99%

Patient‐reported and performance‐based measures of walking in mild–moderate Parkinson's disease

et al. 2018

View full text Add to dashboard Cite

BackgroundKnowledge of the relationships between patient‐reported and performance‐based walking measures in Parkinson's disease (PD) should inform clinical decision‐making. The Walk‐12G reliably captures perceived walking difficulties but has not been compared to performance‐based walking in laboratory or free‐living settings or across different groups.ObjectivesTo investigate the relationship between patient‐reported walking difficulties (Walk‐12G) and performance‐based walking in laboratory and free‐living conditions and to determine whether the Walk‐12G can distinguish between the subgroups, (i) people with/without PD and (ii) mild/moderate disease stages.MethodsForty‐seven people without and 49 people with PD (Hoehn and Yahr stage II and III) were assessed in relation to patient‐reported walking difficulties (Walk‐12G scale); spatiotemporal gait characteristics (Pace; Rhythm; Asymmetry; Variability; and Postural control) using a laboratory‐based electronic walkway; and walking behavior (mean steps/day and minutes of brisk walking/day) using accelerometers in free‐living conditions.ResultsThe Walk‐12G correlated moderately with the spatiotemporal domain step velocity (r = −0.46) and walking behavior, measured as mean steps/day (r = −0.46). Weaker correlations were observed for step length and minutes spent in brisk walking (r = −0.36 and r = −0.35, respectively). Poor correlations were observed for all other spatiotemporal domains. The Walk‐12G could distinguish between people with and without PD (Effect size, r = 0.82) and between those at mild/moderate disease stages (r = 0.34).ConclusionsPerceived walking difficulties showed weak to moderate associations with performance‐based measures of walking in mild–moderate PD. As the strongest associations were observed for step velocity and walking behavior, targeting these specific gait aspects could improve perceived walking difficulties in daily life.

show abstract

Neural Control of Walking in People with Parkinsonism

Cited by 134 publications

References 157 publications

Subtle gait and balance impairments occur in idiopathic rapid eye movement sleep behavior disorder

Subtle gait and balance impairments occur in idiopathic rapid eye movement sleep behavior disorder

Resting‐state functional connectivity of subcortical locomotor centers explains variance in walking capacity

Patient‐reported and performance‐based measures of walking in mild–moderate Parkinson's disease

Contact Info

Product

Resources

About