Neurological gait disorders in elderly people: clinical approach and classification

Snijders, Anke H.; Warrenburg, Bart P. van de; Giladi, Nir; Bloem, Bastiaan R.

doi:10.1016/s1474-4422(06)70678-0

Cited by 421 publications

(329 citation statements)

References 89 publications

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“…The findings revealed that the Met/Met genotype was associated with reduced gait velocity in non-demented older adults and that this association was more pronounced in men. Cortical control of gait is complex with frontal basal ganglia circuitry having a prominent role (for review see Snijders, van de Warrenburg, Giladi, & Bloem, 2007). Although COMT functionality appears to be predominantly at the level of the cortex (Tunbridge, Harrison, & Weinberger, 2006) it also affects dopamine neurotransmission in the striatum Meyer-Lindenberg et al, 2005) where significant age-related pre and post-synaptic losses have been reported (Backman, Nyberg, Lindenberger, Li, & Farde, 2006).…”

Section: Discussionmentioning

confidence: 99%

Differential effects of COMT on gait and executive control in aging

Holtzer

Ozelius

Xue

et al. 2010

Neurobiology of Aging

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Walking speed is associated with attention and executive control processes subserved by the prefrontal cortex. Because polymorphisms in COMT influence these cognitive processes we hypothesized that the same polymorphisms may influence gait velocity. We examined the associations between the Val 158 Met polymorphism in COMT and gait velocity as well as attention and executive function. Participants were 278 non-demented older adults. The results revealed that Met/Val was associated with faster gait velocity. This association can be explained by the putative role of the Val allele in regulating tonic dopamine release in the striatum. In contrast, Met/Met was associated with better attention and executive function. Stratification by gender revealed that the association between COMT genotype and gait was significant only in men. Conversely, the association between COMT genotype and attention and executive function was significant only in women. These findings suggest a differential effect in relating the Val 158 Met polymorphism to gait and to cognitive function while supporting the previously described sexual dimorphism in the phenotypic expressions of COMT.

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Section: Discussionmentioning

confidence: 99%

Differential effects of COMT on gait and executive control in aging

Holtzer

Ozelius

Xue

et al. 2010

Neurobiology of Aging

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“…For instance, the impairments of PD patients in initiating internally generated movements (Brown and Marsden, 1988) can be seen as a reflection of altered ability to select a change from the previously held posture. Similarly, the slowing and cessation of movements ("freezing") that occurs when patients have to switch from one motor program to another (e.g., when turning during walking) (Snijders et al, 2007) could be related to altered switching abilities.…”

Section: The Effect Of Striatal Dysfunction On Action Switchingmentioning

confidence: 99%

Increased Dependence of Action Selection on Recent Motor History in Parkinson's Disease

Helmich

Aarts²,

Lange³

et al. 2009

J. Neurosci.

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It is well known that the basal ganglia are involved in switching between movement sequences. Here we test the hypothesis that this contribution is an instance of a more general role of the basal ganglia in selecting actions that deviate from the context defined by the recent motor history, even when there is no sequential structure to learn or implement. We investigated the effect of striatal dopamine depletion [in Parkinson's disease (PD)] on the ability to switch between independent action plans. PD patients with markedly lateralized signs performed a hand laterality judgment task that involved action selection of their most and least affected hand. Trials where patients selected the same (repeat) or the alternative (switch) hand as in a previous trial were compared, and this was done separately for the most and least affected hand. Behaviorally, PD patients showed switch-costs that were specific to the most affected hand and that increased with disease severity. Functional magnetic resonance imaging (fMRI) showed that this behavioral effect was related to the state of the frontostriatal system: as disease severity increased, contributions of the basal ganglia to the selection process and their effective connectivity with the medial frontal cortex (MFC) decreased, whereas involvement of the MFC increased. We conclude that the basal ganglia are important for rapidly switching toward novel motor plans even when there is no sequential structure to learn or implement. The enhanced MFC activity may result either from reduced focusing abilities of the basal ganglia or from compensatory processes.

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“…In addition, ageing may be associated with gradual dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis leading to elevated glucocorticoid levels in elderly [9][10][11]. Increased basal circulating stress hormone levels [12] may contribute to age-related functional decline [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Synergistic effects of age and stress in a rodent model of stroke

Merrett

Kirkland

Metz

2010

Behavioural Brain Research

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Ageing and stress represent critical influences on stroke risk and outcome. These variables are intricately linked, as ageing is frequently associated with gradual dysregulation of the hypothalamic-pituitary-adrenal axis. This study determined the effects of stress on motor function in aged rats, and explored possible interactions of age and stress on motor recovery following stroke in a rat model. Young adult (4 months) and aged (18 months) male Wistar rats were tested in skilled and non-skilled movement before and after focal ischemia in motor cortex. One group of each age received restraint stress starting seven days pre-lesion until three weeks post-lesion. Aged rats were less mobile and stress further diminished their overall exploratory activity. Aged rats were also less proficient in motor skill acquisition and slower to improve after lesion. Stress diminished post-lesion improvement and prevented recovery of endpoint measures. The larger functional loss in aged rats vs. young rats was accompanied by greater damage of cortical tissue and persistent elevations in corticosterone levels. The behavioural and physiological measures suggest limited ability of aged animals to adapt to chronic stress. These findings show that age or stress alone can modulate motor performance but may have greater influence by synergistically affecting stroke recovery.

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Neurological gait disorders in elderly people: clinical approach and classification

Cited by 421 publications

References 89 publications

Differential effects of COMT on gait and executive control in aging

Differential effects of COMT on gait and executive control in aging

Increased Dependence of Action Selection on Recent Motor History in Parkinson's Disease

Synergistic effects of age and stress in a rodent model of stroke

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