Objective: In persons with Parkinson’s disease (PwPD), to observe brain activity in prefrontal cortex (PFC) using fNIRS during naturalistic walking that mimics everyday scenarios¹, with a focus on single- and dual-task walking.

Background: PD is associated with reduced automaticity of movement, including walking. To compensate, PwPD allocate attentional resources to walking, leading to difficulty engaging in simultaneous tasks such as cognition (dual-tasking, DT)^2-5. Standard study paradigms collect data in ordered blocks of rest, single-task (ST) cognition, ST walking, and DT (cognition while walking) but in the real world, such activities occur in changing orders, presumably requiring changing resources especially from PFC.

Method: We assessed 12 PwPD of mild-moderate disease severity (mean age 68.0, SD 6.1) on overground ST and DT walking using a varying baseline design with 9 conditions (4 trials each); e.g., ST walking was preceded by 3 baselines: rest, ST cognition, and DT walking. fNIRS probe covered 6 left and right PFC regions of interest (ROIs): inferior, middle, and superior. Cortical activity was indexed by oxygenated hemoglobin (HbO in M mm). We also assessed PFC-dependent executive function and working memory to relate to brain activity patterns.

Results: There were clear differences in PFC activity depending on baseline: (1) For ST walking, significantly less activation following DT walking baseline than either rest or ST cognition baselines, in all ROIs; (2) For DT walking, significantly less activation following ST walking baseline than either rest or ST cognition baselines, in 5/6 ROIs. In each case this relatively low activation was less prominent in PwPD with poorer executive function and working memory.

Conclusion: Conclusions: The results suggest that PwPD increase PFC-based activation as they move from one everyday condition (rest or cognition) to another, more attention-demanding one (ST or DT walking), and they reduce this activation moving from attention-demanding walking (ST or DT) to non-walking conditions. This ability to change resource allocation is stronger in PwPD with sufficient brain integrity to also perform well on PFC-based cognitive tasks. Our findings indicate the value of varying-baseline design in assessing brain activation in PwPD as they engage in everyday tasks.

References: 1. Von Lühmann, A., Zheng, Y., Ortega-Martinez, A., Kiran, S., Somers, D.C., Cronin-Golomb, A., Awad, L.N., Ellis, T.D., Boas, D.A., Yücel, M.A. (2021). Towards Neuroscience of the Everyday World (NEW) using functional near infrared spectroscopy. Current Opinion in Biomedical Engineering, 18 (June): 100272
2. Chen, Y.-A., Wu, R.-M., Sheu, C.-H., Lin, C.-H., & Huang, C.-Y. (2022). Attentional focus effect on dual-task walking in Parkinson’s disease with and without freezing of gait. GeroScience, 45, 177-195.
3. Lord, S., Rochester, L., Hetherington, V., Allcock, L.M., Burn, D. (2010). Executive dysfunction and attention contribute to gait interference in ‘off’ state Parkinson’s disease. Gait & Posture, 31, 169-174.
4. Salazar, R. D., Ren, X., Ellis, T. D., Toraif, N., Barthelemy, O. J., Neargarder, S., & Cronin-Golomb, A. (2017). Dual tasking in Parkinson’s disease: Cognitive consequences while walking. Neuropsychology, 31, 613-623.
5. Wu, T., Hallett, M. & Chan, P. (2015). Motor automaticity in Parkinson’s disease. Neurobiology of Disease, 82, 226–234.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/naturalistic-walking-in-parkinsons-disease-prefrontal-cortex-activity-measured-with-functional-near-infrared-spectroscopy-fnirs/