Objective: To investigate the effects of a 5-weeks intensive rehabilitation program on prefrontal activation during walking in patients with Parkinson Disease (PD).

Background: Several studies showed beneficial effects of physical exercise on cognition and prefrontal plasticity in patients with PD. In Lyon (France), an intensive collective multidisciplinary rehabilitation program was developed for PD patients, focusing on intensive-high amplitude movements and loudness in the speech. Several types of exercises are conducted such as adapted physical activity, occupational, speech and physical therapy, 5 days a week during 5 weeks.

Method: In this on-going study, PD patients are assessed at 3 different times: 5 weeks before beginning the program (T0), few days before (T1) and one week after (T2). At each assessment, participants perform three conditions: (1) a single-task self-selected walking, (2) a dual-task walking while subtracting and (3) a subtracting task while standing. A portable functional near infrared spectroscopy (fNIRS) system measures the dorsolateral prefrontal cortex (DLPFC) activation, i.e., changes in oxygenated hemoglobin concentrations. Two foot-sensors are used to extract gait features such as gait speed.

Results: To date, we collected data from only 6 patients. Premilinary results indicate that in the single-task walking, DLPFC activity in patients decreased at T2 compared to T0 and T1 whereas gait speed increased. In the dual task walking, DLPFC activity increased at T2 compared to T0 and T1 along with gait speed and the number of correct subtractions. In the single task subtracting, DLPFC activity increased at T2 compared to T0 and T1 as well as the number of correct subtractions. Statistical analysis will be performed in a larger sample size.

Conclusion: Our preliminary results suggest that this rehabilitation program modifies the prefrontal activation in PD patients. A decrease of prefrontal activity during the single task walking after the program may indicate that PD patients need fewer cognitive resources to walk in simple condition. Moreover, an increase of prefrontal activity during the dual task walking with an improvement of gait speed after the program may reflect a better utilization of cognitive resources to allow better walking performance during complex conditions.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-an-intensive-rehabilitation-program-sirocco-on-prefrontal-activity-during-walking-in-patients-with-parkinson-disease/