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Glatt S, Shohat S, Yam M, Goldstein L, Maidan I, Fahoum F. Cannabidiol-enriched oil for adult patients with drug-resistant epilepsy: Prospective clinical and electrophysiological study. Epilepsia 2024. [PMID: 38808601 DOI: 10.1111/epi.18025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 05/10/2024] [Accepted: 05/10/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVE Cannabidiol-enriched oil (CBDO) is being used increasingly to improve seizure control in adult patients with drug-resistant epilepsy (DRE), despite the lack of large-scale studies supporting its efficacy in this patient population. We aimed to assess the effects of add-on CBDO on seizure frequency as well as on gait, cognitive, affective, and sleep-quality metrics, and to explore the electrophysiological changes in responder and non-responder DRE patients treated with add-on CBDO. METHODS We prospectively recruited adult DRE patients who were treated with add-on CBDO. Patients were evaluated prior to treatment and following 4 weeks of a maintenance daily dose of ≈260 mg CBD and ≈12 mg Δ9-tetrahydrocannabinol (THC). The outcome measures included seizure response to CBDO (defined as ≥50% decrease in seizures compared to pre-CBDO baseline), gait testing, Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS), and sleep-quality questionnaire assessments. Patients underwent electroencephalography (EEG) recording during rest as well as event-related potentials (ERPs) during visual Go/NoGo task while sitting and while walking. RESULTS Nineteen patients were recruited, of which 16 finished pre- and post-CBDO assessments. Seven patients (43.75%) were responders demonstrating an average reduction of 82.4% in seizures, and nine patients (56.25%) were non-responders with an average seizure increase of 30.1%. No differences in demographics and clinical parameters were found between responders and non-responders at baseline. However, responders demonstrated better performance in the dual-task walking post-treatment (p = .015), and correlation between increase in MoCA and seizure reduction (r = .810, p = .027). Post-CBDO P300 amplitude was lower during No/Go-sitting in non-responders (p = .028) and during No/Go-walking in responders (p = .068). SIGNIFICANCE CBDO treatment can reduce seizures in a subset of patients with DRE, but could aggravate seizure control in a minority of patients; yet we found no specific baseline clinical or electrophysiological characteristics that are associated with response to CBDO. However, changes in ERPs in response to treatment could be a promising direction to better identify patients who could benefit from CBDO treatment.
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Affiliation(s)
- Sigal Glatt
- Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sophie Shohat
- Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Mor Yam
- Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lilach Goldstein
- Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Inbal Maidan
- Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Firas Fahoum
- Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Papin LJ, Esche M, Scanlon JEM, Jacobsen NSJ, Debener S. Investigating cognitive-motor effects during slacklining using mobile EEG. Front Hum Neurosci 2024; 18:1382959. [PMID: 38818032 PMCID: PMC11137308 DOI: 10.3389/fnhum.2024.1382959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/24/2024] [Indexed: 06/01/2024] Open
Abstract
Balancing is a very important skill, supporting many daily life activities. Cognitive-motor interference (CMI) dual-tasking paradigms have been established to identify the cognitive load of complex natural motor tasks, such as running and cycling. Here we used wireless, smartphone-recorded electroencephalography (EEG) and motion sensors while participants were either standing on firm ground or on a slackline, either performing an auditory oddball task (dual-task condition) or no task simultaneously (single-task condition). We expected a reduced amplitude and increased latency of the P3 event-related potential (ERP) component to target sounds for the complex balancing compared to the standing on ground condition, and a further decrease in the dual-task compared to the single-task balancing condition. Further, we expected greater postural sway during slacklining while performing the concurrent auditory attention task. Twenty young, experienced slackliners performed an auditory oddball task, silently counting rare target tones presented in a series of frequently occurring standard tones. Results revealed similar P3 topographies and morphologies during both movement conditions. Contrary to our predictions we observed neither significantly reduced P3 amplitudes, nor significantly increased latencies during slacklining. Unexpectedly, we found greater postural sway during slacklining with no additional task compared to dual-tasking. Further, we found a significant correlation between the participant's skill level and P3 latency, but not between skill level and P3 amplitude or postural sway. This pattern of results indicates an interference effect for less skilled individuals, whereas individuals with a high skill level may have shown a facilitation effect. Our study adds to the growing field of research demonstrating that ERPs obtained in uncontrolled, daily-life situations can provide meaningful results. We argue that the individual CMI effects on the P3 ERP reflects how demanding the balancing task is for untrained individuals, which draws on limited resources that are otherwise available for auditory attention processing. In future work, the analysis of concurrently recorded motion-sensor signals will help to identify the cognitive demands of motor tasks executed in natural, uncontrolled environments.
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Affiliation(s)
- Lara J. Papin
- Neuropsychology Lab, Department of Psychology, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Manik Esche
- Neuropsychology Lab, Department of Psychology, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Joanna E. M. Scanlon
- Neuropsychology Lab, Department of Psychology, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
- Oldenburg Branch for Hearing, Speech and Audio Technology (HSA), Fraunhofer Institute for Digital Media Technology (IDMT), Oldenburg, Germany
| | - Nadine S. J. Jacobsen
- Neuropsychology Lab, Department of Psychology, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Stefan Debener
- Neuropsychology Lab, Department of Psychology, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
- Oldenburg Branch for Hearing, Speech and Audio Technology (HSA), Fraunhofer Institute for Digital Media Technology (IDMT), Oldenburg, Germany
- Cluster of Excellence Hearing4all, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
- Center for Neurosensory Science and Systems, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
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Chan HL, Ouyang Y, Lai CC, Lin MA, Chang YJ, Chen SW, Liaw JW, Meng LF. Event-related brain potentials reveal enhancing and compensatory mechanisms during dual neurocognitive and cycling tasks. BMC Sports Sci Med Rehabil 2023; 15:133. [PMID: 37845733 PMCID: PMC10580529 DOI: 10.1186/s13102-023-00749-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/10/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Various neurocognitive tests have shown that cycling enhances cognitive performance compared to resting. Event-related potentials (ERPs) elicited by an oddball or flanker task have clarified the impact of dual-task cycling on perception and attention. In this study, we investigate the effect of cycling on cognitive recruitment during tasks that involve not only stimulus identification but also semantic processing and memory retention. METHODS We recruited 24 healthy young adults (12 males, 12 females; mean age = 22.71, SD = 1.97 years) to perform three neurocognitive tasks (namely color-word matching, arithmetic calculation, and spatial working memory) at rest and while cycling, employing a within-subject design with rest/cycling counterbalancing. RESULTS The reaction time on the spatial working memory task was faster while cycling than at rest at a level approaching statistical significance. The commission error percentage on the color-word matching task was significantly lower at rest than while cycling. Dual-task cycling while responding to neurocognitive tests elicited the following results: (a) a greater ERP P1 amplitude, delayed P3a latency, less negative N4, and less positivity in the late slow wave (LSW) during color-word matching; (b) a greater P1 amplitude during memory encoding and smaller posterior negativity during memory retention on the spatial working memory task; and (c) a smaller P3 amplitude, followed by a more negative N4 and less LSW positivity during arithmetic calculation. CONCLUSION The encoding of color-word and spatial information while cycling may have resulted in compensatory visual processing and attention allocation to cope with the additional cycling task load. The dual-task cycling and cognitive performance reduced the demands of semantic processing for color-word matching and the cognitive load associated with temporarily suspending spatial information. While dual-tasking may have required enhanced semantic processing to initiate mental arithmetic, a compensatory decrement was noted during arithmetic calculation. These significant neurocognitive findings demonstrate the effect of cycling on semantic-demand and memory retention-demand tasks.
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Affiliation(s)
- Hsiao-Lung Chan
- Department of Electrical Engineering, Chang Gung University, Taoyuan, Taiwan
- Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yuan Ouyang
- Department of Electrical Engineering, Chang Gung University, Taoyuan, Taiwan
- Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Cheng-Chou Lai
- Department of Electrical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Ming-An Lin
- Faculty of Computer and Software Engineering, Huaiyin Institute of Technology, Huaian, Taiwan, Jiang-Su
| | - Ya-Ju Chang
- Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, and Health Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Szi-Wen Chen
- Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Electronic Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Jiunn-Woei Liaw
- Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan
- Center for Advanced Molecular Imaging and Translation, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ling-Fu Meng
- Department of Occupational Therapy and Graduate Institute of Behavioral Science, College of Medicine, Chang Gung University, No.259, Wenhua 1st Rd., Guishan Dist, Taoyuan, 33302, Taiwan.
- Division of Occupational Therapy, Department of Rehabilitation, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.
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Shkury E, Danziger-Schragenheim S, Katzir Z, Ezra Y, Giladi N, Mirelman A, Maidan I. Differences in EEG Event-Related Potentials during Dual Task in Parkinson's Disease Carriers and Non-Carriers of the G2019S-LRRK2 Mutation. SENSORS (BASEL, SWITZERLAND) 2023; 23:8266. [PMID: 37837096 PMCID: PMC10575245 DOI: 10.3390/s23198266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/28/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND The G2019S-LRRK2 gene mutation is a common cause of hereditary Parkinson's disease (PD), associated with a higher frequency of the postural instability gait difficulty (PIGD) motor phenotype yet with preserved cognition. This study investigated neurophysiological changes during motor and cognitive tasks in PD patients with and without the G2019S-LRRK2 mutation. METHODS 33 iPD patients and 22 LRRK2-PD patients performed the visual Go/NoGo task (VGNG) during sitting (single-task) and walking (dual-task) while wearing a 64-channel EEG cap. Event-related potentials (ERP) from Fz and Pz, specifically N200 and P300, were extracted and analyzed to quantify brain activity patterns. RESULTS The LRRK2-PD group performed better in the VGNG than the iPD group (group*task; p = 0.05). During Go, the iPD group showed reduced N2 amplitude and prolonged N2 latency during walking, whereas the LRRK2-PD group showed only shorter latency (group*task p = 0.027). During NoGo, opposite patterns emerged; the iPD group showed reduced N2 and increased P3 amplitudes during walking while the LRRK2-PD group demonstrated increased N2 and reduced P3 (N2: group*task, p = 0.010, P3: group*task, p = 0.012). CONCLUSIONS The LRRK2-PD group showed efficient early cognitive processes, reflected by N2, resulting in greater neural synchronization and prominent ERPs. These processes are possibly the underlying mechanisms for the observed better cognitive performance as compared to the iPD group. As such, future applications of intelligent medical sensing should be capable of capturing these electrophysiological patterns in order to enhance motor-cognitive functions.
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Affiliation(s)
- Eden Shkury
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; (E.S.); (S.D.-S.); (Z.K.); (Y.E.); (N.G.); (A.M.)
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Shani Danziger-Schragenheim
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; (E.S.); (S.D.-S.); (Z.K.); (Y.E.); (N.G.); (A.M.)
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Zoya Katzir
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; (E.S.); (S.D.-S.); (Z.K.); (Y.E.); (N.G.); (A.M.)
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Yael Ezra
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; (E.S.); (S.D.-S.); (Z.K.); (Y.E.); (N.G.); (A.M.)
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Nir Giladi
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; (E.S.); (S.D.-S.); (Z.K.); (Y.E.); (N.G.); (A.M.)
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Anat Mirelman
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; (E.S.); (S.D.-S.); (Z.K.); (Y.E.); (N.G.); (A.M.)
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Inbal Maidan
- Laboratory of Early Markers of Neurodegeneration, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; (E.S.); (S.D.-S.); (Z.K.); (Y.E.); (N.G.); (A.M.)
- School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
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Menacho MDO, Pacheco-Barrios K, Mendes AJ, Sato TDO, Fregni F, Gianlorenço ACL. Exercise effects on motor function, manual dexterity, and brain oscillatory activity in individuals with Parkinson's disease: Randomized controlled trial protocol. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2023; 28:e2009. [PMID: 37141404 DOI: 10.1002/pri.2009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 03/15/2023] [Accepted: 04/17/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Parkinson's disease (PD) is the second most common progressive neurodegenerative disorder. Exercise protocols are promising interventions to improve PD symptoms, however, the best modality and its neural correlates are still unknown. OBJECTIVES To evaluate the effects of the aerobic, strength and task-oriented upper-limb exercises in motor function, manual dexterity, and brain oscillations of individuals with PD. METHOD In this clinical trial, 44 PD patients aged 40-80 years will be randomized in four groups: aerobic training (AT), strength training (ST), task-oriented training (TOT), and waiting list group (CG). The AT group will perform 30 min of a cycle ergometer on 50%-70% of the reserve heart rate. The ST group will use equipment for upper limb muscles and will perform two series of 8-12 repetitions for each exercise, and intensity between 50% and 70% of one maximum repetition will be used. The TOT group will perform a program consisting of three activities to enhance reaching, grasping, and manipulation. All the groups will perform three sessions per week for 8 weeks. We will use the UPDRS Motor function section, Nine-Hole Peg Test, and quantitative electroencephalography to measure motor function, manual dexterity, and brain oscillations, respectively. ANOVA and regression models will be used to compare outcomes within and between groups.
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Affiliation(s)
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | - Augusto J Mendes
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Laboratory of Neuroimaging of Aging, LANVIE, University of Geneva, Geneva, Switzerland
- Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | | | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Anna Carolyna Lepesteur Gianlorenço
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, Brazil
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Fernandez-Del-Olmo M, Sánchez-Molina JA, Novo-Ponte S, Fogelson N. Directed connectivity in Parkinson's disease patients during over-ground and treadmill walking. Exp Gerontol 2023; 178:112220. [PMID: 37230335 DOI: 10.1016/j.exger.2023.112220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 05/27/2023]
Abstract
Treadmill walking is considered a useful therapeutic tool for improving gait in Parkinson's disease (PD) patients. The study investigated the role of top-down, frontal-parietal versus bottom-up parietal-frontal networks, during over-ground and treadmill walking in PD and control subjects, using functional connectivity. To this end, EEG was recorded simultaneously, during a ten-minute period of continuous walking either over-ground or on a treadmill, in thirteen PD patients and thirteen age-matched controls. We evaluated EEG directed connectivity, using phase transfer entropy in three frequency bands: theta, alpha and beta. PD patients showed increased top-down connectivity during over-ground compared with treadmill walking, in the beta frequency range. Control subjects showed no significant differences in connectivity between the two walking conditions. Our results suggest that in PD patients, OG walking was associated with increased allocation of attentional resources, compared with that on the TL. These functional connectivity modulations may shed further light on the mechanisms underlying treadmill versus overground walking in PD.
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Affiliation(s)
| | | | - Sabela Novo-Ponte
- Department of Neurology, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Noa Fogelson
- Department of Humanities, University Rey Juan Carlos, Madrid, Spain.
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Parveen S, Noohu MM. Association between P300 parameters and cognitive function in people with diabetic neuropathy. J Diabetes Metab Disord 2023; 22:347-354. [PMID: 37255838 PMCID: PMC10225418 DOI: 10.1007/s40200-022-01148-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 06/01/2023]
Abstract
Purpose The purpose of this study was to investigate the association between event-related potential (ERP) P300 with cognitive function in people with diabetic peripheral neuropathy (DPN). Methods We performed a cross-sectional analysis of 19 type 2 diabetes mellitus (T2DM) patients, aged 18 and older with DPN. The participants were assessed for neuropathy, cognitive function, & dual-task performance. DPN was examined via the administration of diabetic neuropathy symptom score (DNSS) and vibration perception threshold (VPT). Cognitive dysfunction was evaluated using Mini-mental state examination (MMSE), trail making test-B (TMT-B), and ERP P300 wave latency & amplitude. For assessing dual-task performance, the dual-task cost (DTC) was calculated using the timed-up and go (TUG) test and TUG with dual task (TUG-DT). Results P300 latency was linearly related to TMT-B (R = 0.31, p = 0.01) and DTC (R = 0.22, p = 0.04). A similar trend was observed in TMT-B (R = 0.13, p = 0.04) & DTC (R =0 .67, p = 0.001) with respect to P300 amplitude. MMSE did not relate with P300 latency (R = 0.14, p = 0.58) & amplitude (R = 0.63, p = .44). Conclusion P300 latency and amplitude are associated with cognitive function and DTC of individuals with DPN.
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Affiliation(s)
- Sarah Parveen
- Centre for Physiotherapy & Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
| | - Majumi M. Noohu
- Centre for Physiotherapy & Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
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Vandenheever D, Lambrechts M. Dual-task changes in gait and brain activity measured in a healthy young adult population. Gait Posture 2023; 103:119-125. [PMID: 37156164 DOI: 10.1016/j.gaitpost.2023.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 04/12/2023] [Accepted: 04/26/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Dual Task (DT) walking in everyday life is the norm rather than the exception. Complex cognitive-motor strategies are employed during DT and it is necessary to coordinate and regulate neural resources to ensure adequate performance. However, the underlying neurophysiology involved is not fully understood. Therefore, the aim of this study was to examine the neurophysiology and gait kinematics during DT gait. RESEARCH QUESTION Our main research question was whether gait kinematics changed during DT walking for healthy young adults and whether this is reflected in brain activity. METHODS Ten healthy young adults walked on a treadmill, performed a Flanker test while standing and performed the Flanker test while walking on a treadmill. Electroencephalography (EEG), spatial temporal, and kinematic data was recorded and analyzed. RESULTS Average alpha and beta activities were modulated during DT walking compared to single task (ST) walking while ERPs during the Flanker test showed larger P300 amplitudes and longer latencies for DT compared to standing. Cadence reduced and cadence variability increased during DT compared to ST whilst kinematic results showed that hip and knee flexions decreased, and the center of mass moved slightly back in the sagittal plane. SIGNIFICANCE It was found that healthy young adults employed a cognitive-motor strategy that included directing more neural resources to the cognitive task while adopting a more upright posture during DT walking.
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Affiliation(s)
- David Vandenheever
- Neural Engineering Research Division, Agricultural and Biological Engineering Department, Mississippi State University, MS, USA; Department of Mechanical and Mechatronic Engineering, Stellenbosch University, Stellenbosch, South Africa.
| | - Marezelle Lambrechts
- Department of Mechanical and Mechatronic Engineering, Stellenbosch University, Stellenbosch, South Africa
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Frase L, Feige B, Gioia I, Loeck VK, Domschke K, Dressle RJ, Kilian H, Spiegelhalder K, Schläpfer T, Riemann D. No alterations in potential indirect markers of locus coeruleus-norepinephrine function in insomnia disorder. J Sleep Res 2023:e13872. [PMID: 36889676 DOI: 10.1111/jsr.13872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/03/2023] [Accepted: 02/24/2023] [Indexed: 03/10/2023]
Abstract
The norepinephrine locus coeruleus system (LC NE) represents a promising treatment target in patients with insomnia disorder (ID) due to its well understood links to arousal and sleep regulation. However, consistent markers of LC NE activity are lacking. This study measured three potential indirect markers of LC NE activity - REM sleep, P3 amplitude during an auditory oddball paradigm (as a marker of phasic LC activation), and baseline pupil diameter (as a marker of tonic LC activation). The parameters were then combined in a statistical model and tested to compare LC NE activity between 20 subjects with insomnia disorder (13 female; age 44.2 ± 15.1 year) and 20 healthy, good sleeping controls (GSC; 11 female; age 45.4 ± 11.6 year). No group differences regarding the primary outcome parameters were detected. Specifically, insomnia disorder did not display the hypothesised changes in markers of LC NE function. While increased LC NE function remains an interesting speculative pathway for hyperarousal in insomnia disorder, the investigated markers do not appear closely related to each other and fail to discriminate between insomnia disorder and good sleeping controls in these samples.
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Affiliation(s)
- Lukas Frase
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg - Faculty of Medicine, University of Freiburg, Breisgau, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Medical Center, University of Freiburg - Faculty of Medicine, University of Freiburg, Breisgau, Germany
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg - Faculty of Medicine, University of Freiburg, Breisgau, Germany
| | - Isabella Gioia
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg - Faculty of Medicine, University of Freiburg, Breisgau, Germany
| | - Viveka K Loeck
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg - Faculty of Medicine, University of Freiburg, Breisgau, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg - Faculty of Medicine, University of Freiburg, Breisgau, Germany.,Center for Basics in Neuromodulation, University of Freiburg - Faculty of Medicine, Freiburg, Germany
| | - Raphael J Dressle
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg - Faculty of Medicine, University of Freiburg, Breisgau, Germany
| | - Hannah Kilian
- Division for Interventional Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg - Faculty of Medicine, University of Freiburg, Breisgau, Germany
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg - Faculty of Medicine, University of Freiburg, Breisgau, Germany
| | - Thomas Schläpfer
- Division for Interventional Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg - Faculty of Medicine, University of Freiburg, Breisgau, Germany
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg - Faculty of Medicine, University of Freiburg, Breisgau, Germany
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Jeanne R, Piton T, Minjoz S, Bassan N, Le Chenechal M, Semblat A, Hot P, Kibleur A, Pellissier S. Gut-Brain Coupling and Multilevel Physiological Response to Biofeedback Relaxation After a Stressful Task Under Virtual Reality Immersion: A Pilot Study. Appl Psychophysiol Biofeedback 2023; 48:109-125. [PMID: 36336770 DOI: 10.1007/s10484-022-09566-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 11/08/2022]
Abstract
Human physiological reactions to the environment are coordinated by the interactions between brain and viscera. In particular, the brain, heart, and gastrointestinal tract coordinate with each other to provide physiological equilibrium by involving the central, autonomic, and enteric nervous systems. Recent studies have demonstrated an electrophysiological coupling between the gastrointestinal tract and the brain (gut-brain axis) under resting-state conditions. As the gut-brain axis plays a key role in individual stress regulation, we aimed to examine modulation of gut-brain coupling through the use of an overwhelming and a relaxing module as a first step toward modeling of the underlying mechanisms. This study was performed in 12 participants who, under a virtual reality environment, performed a 9-min cognitive stressful task followed by a 9-min period of relaxation. Brain activity was captured by electroencephalography, autonomic activities by photoplethysmography, and electrodermal and gastric activities by electrogastrography. Results showed that compared with the stressful task, relaxation induced a significant decrease in both tonic and phasic sympathetic activity, with an increase in brain alpha power and a decrease in delta power. The intensity of gut-brain coupling, as assessed by the modulation index of the phase-amplitude coupling between the normogastric slow waves and the brain alpha waves, decreased under the relaxation relative to the stress condition. These results highlight the modulatory effect of biofeedback relaxation on gut-brain coupling and suggest noninvasive multilevel electrophysiology as a promising way to investigate the mechanisms underlying gut-brain coupling in physiological and pathological situations.
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Affiliation(s)
- Rudy Jeanne
- LIP/PC2S, Université Savoie Mont Blanc, Université Grenoble Alpes, 73000, Chambéry, France. .,LPNC, Université Grenoble Alpes, Université Savoie Mont Blanc, 73000, Chambéry, France.
| | - Timothy Piton
- Ecole Polytechnique Fédérale de Lausanne, 1015, Lausanne, Switzerland.,Open Mind Innovation, 75008, Paris, France
| | - Séphora Minjoz
- LIP/PC2S, Université Savoie Mont Blanc, Université Grenoble Alpes, 73000, Chambéry, France.,LPNC, Université Grenoble Alpes, Université Savoie Mont Blanc, 73000, Chambéry, France
| | | | | | | | - Pascal Hot
- LPNC, Université Grenoble Alpes, Université Savoie Mont Blanc, 73000, Chambéry, France.,Institut Universitaire de France, Paris, France
| | | | - Sonia Pellissier
- LIP/PC2S, Université Savoie Mont Blanc, Université Grenoble Alpes, 73000, Chambéry, France
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11
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Du T, Yuan T, Zhu G, Ma R, Zhang X, Chen Y, Zhang J. The effect of age and disease duration on the efficacy of subthalamic nuclei deep brain stimulation in Parkinson's disease patients. CNS Neurosci Ther 2022; 28:2163-2171. [PMID: 36069345 PMCID: PMC9627397 DOI: 10.1111/cns.13958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Previous studies have reported the effects of age and disease duration on the efficacy of subthalamic nuclei deep brain stimulation (STN-DBS) of Parkinson's disease (PD) patients. However, available data involving these issues are not consistent. In particular, the effect of age and disease duration on the initial efficacy of STN-DBS has not been established. METHODS A total of 51 patients with PD treated with bilateral STN-DBS were involved in the present study. They received clinical symptom evaluation during the preoperative, initial, and chronic stages of surgery. The correlations between age when undergoing surgery/age at disease onset/disease duration and outcomes of STN-DBS were measured. RESULTS The preoperative levodopa response was negatively associated with age. During the initial stage, the age when undergoing surgery and age at disease onset were negatively correlated with the effect on bradykinesia, with better symptom control of general symptoms in long-term disease patients. Similarly, patients with an early time of surgery and disease onset and long-term disease duration showed better control of bradykinesia and axial symptoms at the chronic stage. Furthermore, a long-term disease duration and early disease onset benefited from an increase of therapeutic efficacy in general, rigid, and axial symptoms with STN-DBS after a long period. Nevertheless, patients with late disease onset achieved a better relief of stigma. CONCLUSION Age and disease durations played a unique role in controlling the symptoms of PD patients treated with STN-DBS. These results may contribute to patient selection and adjustments of expectations of surgery, based on the age, disease duration, and different symptoms.
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Affiliation(s)
- Tingting Du
- Department of Functional NeurosurgeryBeijing Neurosurgical Institute, Capital Medical UniversityBeijingChina
| | - Tianshuo Yuan
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Guanyu Zhu
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Ruoyu Ma
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Xin Zhang
- Department of Functional NeurosurgeryBeijing Neurosurgical Institute, Capital Medical UniversityBeijingChina
| | - Yingchuan Chen
- Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Jianguo Zhang
- Department of Functional NeurosurgeryBeijing Neurosurgical Institute, Capital Medical UniversityBeijingChina,Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina,Beijing Key Laboratory of NeurostimulationBeijingChina
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12
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Vila-Chã C, Vaz C, Oliveira AS. Electrocortical Activity in Older Adults Is More Influenced by Cognitive Task Complexity Than Concurrent Walking. Front Aging Neurosci 2022; 13:718648. [PMID: 35140598 PMCID: PMC8819066 DOI: 10.3389/fnagi.2021.718648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 12/20/2021] [Indexed: 11/17/2022] Open
Abstract
Human cognitive-motor performance largely depends on how brain resources are allocated during simultaneous tasks. Nonetheless, little is known regarding the age-related changes in electrocortical activity when dual-task during walking presents higher complexity levels. Thus, the aim of this study was to investigate whether there are distinct changes in walking performance and electrocortical activation between young and older adults performing simple and complex upper limb response time tasks. Physically active young (23 ± 3 years, n = 21) and older adults (69 ± 5 years, n = 19) were asked to respond as fast as possible to a single stimuli or a double stimuli appearing on a touch screen during standing and walking. Response time, step frequency, step frequency variability and electroencephalographic (EEG) N200 and P300 amplitudes and latencies from frontal central and parietal brain regions were recorded. The results demonstrated that older adults were 23% slower to respond to double stimuli, whereas younger adults were only 12% slower (p < 0.01). The longer response time for older adults was accompanied by greater step frequency variability following double-stimuli presentations (p < 0.01). Older adults presented reduced N200 and P300 amplitudes compared to younger participants across all conditions (p < 0.001), with no effects of posture (standing vs walking) on both groups (p > 0.05). More importantly, the P300 amplitude was significantly reduced for older adults when responding to double stimuli regardless of standing or walking tasks (p < 0.05), with no changes in younger participants. Therefore, physically active older adults can attenuate potential walking deficits experienced during dual-task walking in simple cognitive tasks. However, cognitive tasks involving decision making influence electrocortical activation due to reduced cognitive resources to cope with the task demands.
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Affiliation(s)
- Carolina Vila-Chã
- Polytechnic of Guarda, Guarda, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, Vila Real, Portugal
| | | | - Anderson Souza Oliveira
- Department of Materials and Production, Aalborg University, Aalborg, Denmark
- *Correspondence: Anderson Souza Oliveira,
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13
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Tortora S, Rubega M, Formaggio E, Marco RD, Masiero S, Menegatti E, Tonin L, Felice AD. Age-related differences in visual P300 ERP during dual-task postural balance. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:6511-6514. [PMID: 34892601 DOI: 10.1109/embc46164.2021.9630088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Standing and concurrently performing a cognitive task is a very common situation in everyday life. It is associated with a higher risk of falling in the elderly. Here, we aim at evaluating the differences of the P300 evoked potential elicited by a visual oddball paradigm between healthy younger (< 35 y) and older (> 64 y) adults during a simultaneous postural task. We found that P300 latency increases significantly (p < 0.001) when the elderly are engaged in more challenging postural tasks; younger adults show no effect of balance condition. Our results demonstrate that, even if the elderly have the same accuracy in odd stimuli detection as younger adults do, they require a longer processing time for stimulus discrimination. This finding suggests an increased attentional load which engages additional cerebral reserves.
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14
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Sosnik R, Danziger-Schragenheim S, Possti D, Fahoum F, Giladi N, Hausdorff JM, Mirelman A, Maidan I. Impaired Inhibitory Control During Walking in Parkinson's Disease Patients: An EEG Study. JOURNAL OF PARKINSONS DISEASE 2021; 12:243-256. [PMID: 34569972 DOI: 10.3233/jpd-212776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The performance on a visual Go/NoGo (VGNG) task during walking has been used to evaluate the effect of gait on response inhibition in young and older adults; however, no work has yet included Parkinson's disease (PD) patients for whom such changes may be even more enhanced. OBJECTIVE In this study, we aimed to explore the effect of gait on automatic and cognitive inhibitory control phases in PD patients and the associated changes in neural activity and compared them with young and older adults. METHODS 30 PD patients, 30 older adults, and 11 young adults performed a visual Go/NoGo task in a sitting position and during walking on a treadmill while their EEG activity and gait were recorded. Brain electrical activity was evaluated by the amplitude, latency, and scalp distribution of N2 and P300 event related potentials. Mix model analysis was used to examine group and condition effects on task performance and brain activity. RESULTS The VGNG accuracy rates in PD patients during walking were lower than in young and older adults (F = 5.619, p = 0.006). For all groups, N2 latency during walking was significantly longer than during sitting (p = 0.013). In addition, P300 latency was significantly longer in PD patients (p < 0.001) and older adults (p = 0.032) during walking compared to sitting and during 'NoGo' trials compared with 'Go' trials. Moreover, the young adults showed the smallest number of electrodes for which a significant differential activation between sit to walk was observed, while PD patients showed the largest with N2 being more strongly manifested in bilateral parietal electrodes during walking and in frontocentral electrodes while seated. CONCLUSION The results show that response inhibition during walking is impaired in older subjects and PD patients and that increased cognitive load during dual-task walking relates to significant change in scalp electrical activity, mainly in parietal and frontocentral channels.
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Affiliation(s)
- Ronen Sosnik
- Faculty of Electrical Engineering, Holon Institute of Technology (H.I.T.), Holon, Israel
| | - Shani Danziger-Schragenheim
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Possti
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel
| | - Firas Fahoum
- Epilepsy and EEG Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel.,Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel
| | - Nir Giladi
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Epilepsy and EEG Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel.,Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel
| | - Jeffrey M Hausdorff
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel.,Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Israel.,Alzheimer's Disease Center and Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Anat Mirelman
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel
| | - Inbal Maidan
- Laboratory of Early Markers of Neurodegeneration (LEMON), Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Department of Neurology, Sackler School of Medicine, Tel Aviv University, Israel
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15
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Kahya M, Lyons KE, Pahwa R, Akinwuntan AE, He J, Devos H. Pupillary Response to Postural Demand in Parkinson's Disease. Front Bioeng Biotechnol 2021; 9:617028. [PMID: 33987171 PMCID: PMC8111006 DOI: 10.3389/fbioe.2021.617028] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/09/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Individuals with Parkinson’s disease (PD) may need to spend more mental and physical effort (i.e., cognitive workload) to maintain postural control. Pupillary response reflects cognitive workload during postural control tasks in healthy controls but has not been investigated as a measure of postural demand in PD. Objectives: To compare pupillary response during increased postural demand using vision occlusion and dual tasking between individuals with PD and healthy controls. Methods: Thirty-three individuals with PD and thirty-five healthy controls were recruited. The four conditions lasted 60 s and involved single balance task with eyes open; single balance task with eyes occluded; dual task with eyes open; dual task with eyes occluded. The dual task comprised the Auditory Stroop test. Pupillary response was recorded using an eye tracker. The balance was assessed by using a force plate. Two-way Repeated Measures ANOVA and LSD post-hoc tests were employed to compare pupillary response and Center of Pressure (CoP) displacement across the four conditions and between individuals with PD and healthy controls. Results: Pupillary response was higher in individuals with PD compared to healthy controls (p = 0.009) and increased with more challenging postural conditions in both groups (p < 0.001). The post-hoc analysis demonstrated increased pupillary response in the single balance eyes occluded (p < 0.001), dual task eyes open (p = 0.01), and dual task eyes occluded (p < 0.001) conditions compared to single task eyes open condition. Conclusion: Overall, the PD group had increased pupillary response with increased postural demand compared to the healthy controls. In the future, pupillary response can be a potential tool to understand the neurophysiological underpinnings of falls risk in the PD population.
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Affiliation(s)
- Melike Kahya
- Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, United States
| | - Kelly E Lyons
- Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Rajesh Pahwa
- Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Abiodun E Akinwuntan
- Office of the Dean, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States.,Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States
| | - Jianghua He
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS, United States
| | - Hannes Devos
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States
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16
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Ferrazoli N, Donadon C, Rezende A, Skarzynski PH, Sanfins MD. The Application of P300-Long-Latency Auditory-Evoked Potential in Parkinson Disease. Int Arch Otorhinolaryngol 2021; 26:e158-e166. [PMID: 35096174 PMCID: PMC8789487 DOI: 10.1055/s-0040-1722250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 11/08/2020] [Indexed: 10/27/2022] Open
Abstract
Abstract
Introduction Parkinson disease (PD) is a degenerative and progressive neurological disorder characterized by resting tremor, stiffness, bradykinesia, and postural instability. Despite the motor symptoms, PD patients also consistently show cognitive impairment or executive dysfunction. The auditory event-related potential P300 has been described as the best indicator of mental function, being highly dependent on cognitive skills, including attention and discrimination.
Objective To review the literature on the application and findings of P300 as an indicator of PD.
Data Analysis The samples ranged from 7 to 166 individuals. Young adult and elderly male patients composed most study samples. The Mini-Mental State Examination test, the Unified Parkinson Disease Rating Scale, and the Hoehn and Yahr Scale were used to assess neurological and cognitive function. In terms of testing hearing function, few studies have focused on parameters other than the P300. The factors we focused on were how the P300 was modified by cognitive effects, its correlation with different PD scales, the effect of performing dual tasks, the effect of fatigue, and the influence of drug treatments.
Conclusion The use of the P300 appears to be an effective assessment tool in patients with PD. This event-related potential seems to correlate well with other neurocognitive tests that measure key features of the disease.
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Affiliation(s)
- Natalia Ferrazoli
- Postgraduate Program in Health, Interdisciplinary Practice and Rehabilitation, Universidade Estadual de Campinas, Campinas, SP, Brazil
- Clinica Ouvire, Campinas, SP, Brazil
| | - Caroline Donadon
- Clinica Ouvire, Campinas, SP, Brazil
- Postgraduate Program in Child and Adolescent Health, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | | | - Piotr H. Skarzynski
- Department of Teleaudiology and Hearing Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
- Department of Heart Failure and Cardiac Rehabilitation, Institute of Sensory Organs, Warsaw, Poland
| | - Milaine Dominici Sanfins
- Clinica Ouvire, Campinas, SP, Brazil
- Centro de Eletrofisiologia e Neuroaudiologia Avançada, Sao Paulo, SP, Brazil
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17
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Beppi C, Ribeiro Violante I, Scott G, Sandrone S. EEG, MEG and neuromodulatory approaches to explore cognition: Current status and future directions. Brain Cogn 2021; 148:105677. [PMID: 33486194 DOI: 10.1016/j.bandc.2020.105677] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/26/2020] [Accepted: 12/27/2020] [Indexed: 01/04/2023]
Abstract
Neural oscillations and their association with brain states and cognitive functions have been object of extensive investigation over the last decades. Several electroencephalography (EEG) and magnetoencephalography (MEG) analysis approaches have been explored and oscillatory properties have been identified, in parallel with the technical and computational advancement. This review provides an up-to-date account of how EEG/MEG oscillations have contributed to the understanding of cognition. Methodological challenges, recent developments and translational potential, along with future research avenues, are discussed.
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Affiliation(s)
- Carolina Beppi
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Department of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
| | - Inês Ribeiro Violante
- Computational, Cognitive and Clinical Neuroscience Laboratory (C3NL), Department of Brain Sciences, Imperial College London, London, United Kingdom; School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom.
| | - Gregory Scott
- Computational, Cognitive and Clinical Neuroscience Laboratory (C3NL), Department of Brain Sciences, Imperial College London, London, United Kingdom.
| | - Stefano Sandrone
- Computational, Cognitive and Clinical Neuroscience Laboratory (C3NL), Department of Brain Sciences, Imperial College London, London, United Kingdom.
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18
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Smith MD, Brazier DE, Henderson EJ. Current Perspectives on the Assessment and Management of Gait Disorders in Parkinson's Disease. Neuropsychiatr Dis Treat 2021; 17:2965-2985. [PMID: 34584414 PMCID: PMC8464370 DOI: 10.2147/ndt.s304567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 08/25/2021] [Indexed: 12/31/2022] Open
Abstract
Gait dysfunction is a key defining feature of Parkinson's disease (PD), and is associated with symptoms of freezing and an increased risk of falls. In this narrative review, we cover the putative mechanisms of gait dysfunction in PD, the assessment of gait abnormalities, and the management of symptoms caused by the inherent difficulty in walking. Our understanding of the causes of gait problems in PD has progressed in recent times, moving from neurocognitive theory to correlates of affected neuronal pathways. In particular, this can be shown to correspond with abnormalities in responses to dual-task paradigms and dysfunction in cholinergic signaling. Great progress has been made in the sophistication and precision of gait assessment; however, it has firmly remained in the research domain. There is significant momentum behind wearable technologies that can be used by patients in their own environment, acting as digital biomarkers that can not only reflect progression but also independently discriminate PD from non-PD individuals. The treatment of gait dysfunction has historically relied on physical therapies and training combined with a view to mitigating the impact of such consequences as falls. Pharmacological therapies that are the mainstay of treatment in PD have tended to address symptoms like bradykinesia; however, optimization of dopaminergic therapies likely has a positive effect on quality of gait. Other targets have been assessed with the goal of improving gait, of which medications that improve cholinergic signaling appear most promising. Neuromodulation techniques are increasingly used in the form of deep-brain stimulation; however, standard targets, such as the globus pallidus interna, have a modest effect on gait. Considerable benefit has been seen through targeting the pedunculopontine nucleus, and a dual-target approach may be warranted. Stimulation of the spinal cord and brain through direct or magnetic approaches has been assessed, but requires further evidence.
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Affiliation(s)
- Matthew D Smith
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Older People's Unit, Royal United Hospital NHS Foundation Trust, Bath, UK
| | - Danielle E Brazier
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emily J Henderson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Older People's Unit, Royal United Hospital NHS Foundation Trust, Bath, UK
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19
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Sidhu A, Cooke A. Electroencephalographic neurofeedback training can decrease conscious motor control and increase single and dual-task psychomotor performance. Exp Brain Res 2021; 239:301-313. [PMID: 33165672 PMCID: PMC7884304 DOI: 10.1007/s00221-020-05935-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 09/24/2020] [Indexed: 11/05/2022]
Abstract
The control of human movements is thought to automize with repetition, promoting consistent execution and reduced dual-task costs. However, contingencies such as illness or constraints to regular movement patterns can promote conscious motor control, which can reduce movement proficiency and make dual-task situations more difficult. This experiment evaluated whether electroencephalographic neurofeedback training can reduce the adverse effects of conscious motor control. Twenty-five participants completed the timed-up-and-go task while wearing a leg brace to de-automize their regular movement, under both single and dual-task (walking + serial sevens) conditions, both before and after 30-min of neurofeedback training. Three different types of neurofeedback were prescribed across three laboratory visits. We hypothesised that training to decrease central EEG alpha-power at scalp sites above the supplementary motor area would facilitate performance compared to opposite (increase central EEG alpha-power) or sham neurofeedback training. Results revealed a pre-test to post-test improvement in performance on the single-task and on both aspects of the dual-task when participants were trained to decrease central EEG alpha-power. There were no benefits of opposite or sham neurofeedback training. Mediation analyses revealed that the improvement in dual-task motor performance was mediated by the improvement in cognitive performance. This suggests that the neurofeedback protocol was beneficial because it helped to reduce conscious control of the motor task. The findings could have important implications for rehabilitation and high-performance (e.g., elite sport) domains; neurofeedback could be prescribed to help alleviate the problems that can arise when individuals exert conscious motor control.
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Affiliation(s)
- Amanpreet Sidhu
- School of Sport, Health and Exercise Sciences, Bangor University, George Building, Gwynedd, Bangor, LL57 2PZ, UK
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand
| | - Andrew Cooke
- School of Sport, Health and Exercise Sciences, Bangor University, George Building, Gwynedd, Bangor, LL57 2PZ, UK.
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20
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Romagnolo A, Zibetti M, Lenzi M, Vighetti S, Pongmala C, Artusi CA, Montanaro E, Imbalzano G, Rizzone MG, Lopiano L. Low frequency subthalamic stimulation and event-related potentials in Parkinson disease. Parkinsonism Relat Disord 2020; 82:123-127. [PMID: 33321451 DOI: 10.1016/j.parkreldis.2020.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND High frequency (130 Hz) subthalamic Deep-Brain-Stimulation (STN-DBS) optimally improves cardinal motor symptoms in Parkinson disease (PD). Low stimulation frequencies (60-80 Hz) improve axial symptoms in some patients and, according to preliminary evidences, may also have a beneficial effect on the cognitive component of motor planning. OBJECTIVE To analyze the configuration of the P300 component of cortical event-related auditory potentials (ERPs), a reliable index of attentive cognitive functions, at different stimulation frequencies in STN-DBS in PD patients. METHODS 12 PD patients underwent ERPs recordings using a standard oddball auditory paradigm with STN-DBS at 60 Hz, 80 Hz, 130 Hz, and OFF-stimulation, applied in a randomized double-blind sequence. ERPs analysis considered the peak amplitude and latency of the P300 components at midline electrode positions (Fz, Cz, Pz). RESULTS P300 latency over Cz and Pz electrodes significantly increased with STN-DBS at 130 Hz compared to OFF-stimulation. P300 latency was also significantly increased, though to a lesser degree, over Pz electrode with stimulation at 80 Hz. No significant P300 latency modifications were detected at 60 Hz stimulation compared to OFF-stimulation condition. P300 amplitude did not change significantly for any of the stimulation conditions tested. CONCLUSIONS Low frequency STN-DBS is associated with minor modifications of P300 latency compared to conventional stimulation at 130 Hz, possibly suggesting that 60 and 80 Hz may have less interference with attentive and cognitive processes in PD patients.
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Affiliation(s)
- Alberto Romagnolo
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Maurizio Zibetti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy.
| | - Marco Lenzi
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Sergio Vighetti
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Chatkaew Pongmala
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Carlo Alberto Artusi
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Elisa Montanaro
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Gabriele Imbalzano
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Mario Giorgio Rizzone
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
| | - Leonardo Lopiano
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Via Cherasco 15, 10126, Turin, Italy
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21
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Ranchet M, Hoang I, Cheminon M, Derollepot R, Devos H, Perrey S, Luauté J, Danaila T, Paire-Ficout L. Changes in Prefrontal Cortical Activity During Walking and Cognitive Functions Among Patients With Parkinson's Disease. Front Neurol 2020; 11:601686. [PMID: 33362703 PMCID: PMC7758480 DOI: 10.3389/fneur.2020.601686] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/16/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Walking becomes more and more degraded as Parkinson's Disease (PD) progresses. Previous research examined factors contributing to this deterioration. Among them, changes in brain cortical activity during walking have been less studied in this clinical population. Objectives: This study aimed to: (1) investigate changes in dorsolateral prefrontal cortex (DLPFC) activation during usual walking and dual-task walking conditions in patients with PD; (2) examine the association between cortical activity and behavioral/cognitive outcomes; and (3) explore which factors best predict increased activation of the DLPFC during usual walking. Methods: Eighteen patients with early stage PD and 18 controls performed 4 conditions: (1) standing while subtracting, (2) usual walking, (3) walking while counting forward, and (4) walking while subtracting. Cortical activity in DLPFC, assessed by changes in oxy-hemoglobin (ΔHbO2) and deoxy-hemoglobin (ΔHbR), was measured using functional near infrared spectroscopy (fNIRS). Gait performance was recorded using wearables sensors. Cognition was also assessed using neuropsychological tests, including the Trail Making Test (TMT). Results: DLPFC activity was higher in patients compared to controls during both usual walking and walking while subtracting conditions. Patients had impaired walking performance compared to controls only during walking while subtracting task. Moderate-to-strong correlations between ΔHbO2 and coefficients of variation of all gait parameters were found for usual walking and during walking while counting forward conditions. Part-B of TMT predicted 21% of the variance of ΔHbO2 during usual walking after adjustment for group status. Conclusions: The increased DLPFC activity in patients during usual walking suggests a potential compensation for executive deficits. Understanding changes in DLPFC activity during walking may have implications for rehabilitation of gait in patients with PD.
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Affiliation(s)
- Maud Ranchet
- TS2-LESCOT, Univ Gustave Eiffel, IFSTTAR, Univ Lyon, Lyon, France
| | - Isabelle Hoang
- TS2-LESCOT, Univ Gustave Eiffel, IFSTTAR, Univ Lyon, Lyon, France
| | - Maxime Cheminon
- Service de Médecine Physique et de Réadaptation Neurologique, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, Lyon, France
| | | | - Hannes Devos
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, The University of Kansas Medical Center, Kansas City, KS, United States
| | - Stephane Perrey
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mînes Ales, Montpellier, France
| | - Jacques Luauté
- Service de Médecine Physique et de Réadaptation Neurologique, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, Lyon, France.,Inserm UMR-S 1028, CNRS UMR 529, ImpAct, Center de Recherche en Neurosciences de Lyon, Université Lyon-1, Bron, France.,Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Teodor Danaila
- Center de Neurosciences Cognitives, Service de Neurologie C, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Université Claude Bernard Lyon I, Lyon, France
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22
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Wang Q, Meng L, Pang J, Zhu X, Ming D. Characterization of EEG Data Revealing Relationships With Cognitive and Motor Symptoms in Parkinson's Disease: A Systematic Review. Front Aging Neurosci 2020; 12:587396. [PMID: 33240076 PMCID: PMC7683572 DOI: 10.3389/fnagi.2020.587396] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/06/2020] [Indexed: 01/08/2023] Open
Abstract
Recent research regards the electroencephalogram (EEG) as a promising method to study real-time brain dynamic changes in patients with Parkinson's disease (PD), but a deeper understanding is needed to discern coincident pathophysiology, patterns of changes, and diagnosis. This review summarized recent research on EEG characterization related to the cognitive and motor functions in PD patients and discussed its potential to be used as diagnostic biomarkers. Thirty papers out of 220 published from 2010 to 2020 were reviewed. Movement abnormalities and cognitive decline are related to changes in EEG spectrum and event-related potentials (ERPs) during typical oddball paradigms and/or combined motor tasks. Abnormalities in β and δ frequency bands are, respectively the main manifestation of dyskinesia and cognitive decline in PD. The review showed that PD patients have noteworthy changes in specific EEG characterizations, however, the underlying mechanism of the interrelation between gait and cognitive is still unclear. Understanding the specific nature of the relationship is essential for development of novel invasive clinical diagnostic and therapeutic methods.
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Affiliation(s)
- Qing Wang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Lin Meng
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Jun Pang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Xiaodong Zhu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Dong Ming
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
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23
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Fearon C, Butler JS, Waechter SM, Killane I, Kelly SP, Reilly RB, Lynch T. Neurophysiological correlates of dual tasking in people with Parkinson's disease and freezing of gait. Exp Brain Res 2020; 239:175-187. [PMID: 33135132 DOI: 10.1007/s00221-020-05968-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 10/21/2020] [Indexed: 11/24/2022]
Abstract
Freezing of gait in people with Parkinson's disease (PwP) is associated with executive dysfunction and motor preparation deficits. We have recently shown that electrophysiological markers of motor preparation, rather than decision-making, differentiate PwP with freezing of gait (FOG +) and without (FOG -) while sitting. To examine the effect of locomotion on these results, we measured behavioural and electrophysiological responses in PwP with and without FOG during a target response time task while sitting (single-task) and stepping-in-place (dual-task). Behavioural and electroencephalographic data were acquired from 18 PwP (eight FOG +) and seven young controls performing the task while sitting and stepping-in-place. FOG + had slower response times while stepping compared with sitting. However, response times were significantly faster while stepping compared with sitting for controls. Electrophysiological responses showed no difference in decision-making potentials (centroparietal positivity) between groups or conditions but there were differences in neurophysiological markers of response inhibition (N2) and motor preparation (lateralized readiness potential, LRP) in FOG + while performing a dual-task. This suggests that the addition of a second complex motor task (stepping-in-place) impacts automatic allocation of resources in FOG +, resulting in delayed response times. The impact of locomotion on the generation of the N2 and LRP potentials, particularly in freezers, indirectly implies that these functions compete with locomotion for resources. In the setting of multiple complex tasks or cognitive impairment, severe motor dysfunction may result, leading to freezing of gait.
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Affiliation(s)
- Conor Fearon
- Trinity Centre for Bioengineering, The School of Medicine and the School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland.
- School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland.
- Dublin Neurological Institute at the Mater Misericordiae University Hospital, 57 Eccles Street, Dublin 7, Ireland.
| | - John S Butler
- Trinity Centre for Bioengineering, The School of Medicine and the School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland.
- School of Mathematical Sciences, Technological University Dublin, Kevin Street, Dublin, Ireland.
- School of Medicine, Trinity College, The University of Dublin, Dublin 2, Ireland.
| | - Saskia M Waechter
- Trinity Centre for Bioengineering, The School of Medicine and the School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland
- School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland
| | - Isabelle Killane
- Trinity Centre for Bioengineering, The School of Medicine and the School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland
- School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland
- School of Mechanical and Design Engineering, Technological University Dublin, Bolton Street, Dublin, Ireland
| | - Simon P Kelly
- School of Electrical and Electronic Engineering, University College Dublin, Dublin 4, Ireland
| | - Richard B Reilly
- Trinity Centre for Bioengineering, The School of Medicine and the School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland
- School of Engineering, Trinity College, The University of Dublin, Dublin 2, Ireland
- School of Medicine, Trinity College, The University of Dublin, Dublin 2, Ireland
| | - Timothy Lynch
- Dublin Neurological Institute at the Mater Misericordiae University Hospital, 57 Eccles Street, Dublin 7, Ireland
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24
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Protzak J, Wiczorek R, Gramann K. Peripheral visual perception during natural overground dual-task walking in older and younger adults. Neurobiol Aging 2020; 98:146-159. [PMID: 33290992 DOI: 10.1016/j.neurobiolaging.2020.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/14/2020] [Accepted: 10/12/2020] [Indexed: 12/20/2022]
Abstract
Little is known about the neurophysiological processes underlying visual processing during active behavior and how these change over the life span. This study investigated early (P1) and later (P3) event-related potentials of the electroencephalogram associated with visual perception in older and younger adults while sitting, standing, and walking. While sitting and standing, accurate performance in both groups was not associated with event-related potential characteristics. During walking, in contrast, prolonged latencies and reduced amplitudes of the P1 were related to slower responses and increased misses, respectively. No covariations of behavior and P3 characteristics were observed. However, prolonged P3 latencies with increasing motor task complexity were present for both age groups, and reduced amplitudes while walking were replicated in younger participants. Older participants were more affected by walking in general as reflected in slower walking speeds as well as reduced accuracy and relative P1 amplitudes. These results provide further insights into cognitive-motor interference during natural walking in younger and older adults on early attentional-perceptual processing stages, even for simple additional visual tasks.
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Affiliation(s)
- Janna Protzak
- Junior Research Group FANS (Pedestrian Assistance System for Older Road User), Technische Universität Berlin, Berlin, Germany.
| | - Rebecca Wiczorek
- Junior Research Group FANS (Pedestrian Assistance System for Older Road User), Technische Universität Berlin, Berlin, Germany
| | - Klaus Gramann
- Biological Psychology and Neuroergonomics, Technische Universität Berlin, Berlin, Germany; School of Computer Science, University of Technology, Sydney, Australia; Center for Advanced Neurological Engineering, University of California San Diego, La Jolla, USA
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25
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Possti D, Fahoum F, Sosnik R, Giladi N, Hausdorff JM, Mirelman A, Maidan I. Changes in the EEG spectral power during dual-task walking with aging and Parkinson's disease: initial findings using Event-Related Spectral Perturbation analysis. J Neurol 2020; 268:161-168. [PMID: 32754831 DOI: 10.1007/s00415-020-10104-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/19/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The ability to maintain adequate motor-cognitive performance under increasing task demands depends on the regulation and coordination of neural resources. Studies have shown that such resources diminish with aging and disease. EEG spectral analysis is a method that has the potential to provide insight into neural alterations affecting motor-cognitive performance. The aim of this study was to assess changes in spectral analysis during dual-task walking in aging and disease METHODS: 10 young adults, ten older adults, and ten patients with Parkinson's disease (PD) completed an auditory oddball task while standing and while walking on a treadmill. Spectral power within four frequency bandwidths, delta (< 4 Hz), theta (4-8 Hz), alpha (8-12 Hz), and beta (12-30 Hz), was calculated using Event-Related Spectral Perturbation (ERSP) analyses and compared between single task and dual task and between groups. RESULTS Differences in ERSP were found in all groups between the single and dual-task conditions. In response to dual-task walking, beta increased in all groups (p < 0.026), delta decreased in young adults (p = 0.03) and patients with PD (0.015) while theta increased in young adults (p = 0.028) but decreased in older adults (p = 0.02) and patients with PD (p = 0.015). Differences were seen between the young, the older adults, and the patients with PD. CONCLUSIONS These findings are the first to show changes in the power of different frequency bands during dual-task walking with aging and disease. These specific brain modulations may reflect deficits in readiness and allocation of attention that may be responsible for the deficits in dual-task performance.
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Affiliation(s)
- Daniel Possti
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Firas Fahoum
- Epilepsy and EEG Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Neurology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronen Sosnik
- Faculty of Electrical Engineering, Holon Institute of Technology (H.I.T.), Holon, Israel
| | - Nir Giladi
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Epilepsy and EEG Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Neurology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jeffrey M Hausdorff
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Orthopedic Surgery, Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Anat Mirelman
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Department of Neurology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Inbal Maidan
- Laboratory of Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel Aviv, Israel. .,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel. .,Department of Neurology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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26
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Luo S, Du L, Cui Y. Potential Therapeutic Applications and Developments of Exosomes in Parkinson’s Disease. Mol Pharm 2020; 17:1447-1457. [DOI: 10.1021/acs.molpharmaceut.0c00195] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Siqi Luo
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, China
| | - Libo Du
- State Key Laboratory for Structural Chemistry of Unstable and Stable Species, Center for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
| | - Yan Cui
- School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, China
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27
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Kahya M, Moon S, Ranchet M, Vukas RR, Lyons KE, Pahwa R, Akinwuntan A, Devos H. Brain activity during dual task gait and balance in aging and age-related neurodegenerative conditions: A systematic review. Exp Gerontol 2019; 128:110756. [PMID: 31648005 PMCID: PMC6876748 DOI: 10.1016/j.exger.2019.110756] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/14/2019] [Accepted: 10/16/2019] [Indexed: 11/18/2022]
Abstract
The aims of this systematic review were to investigate (1) real-time brain activity during DT gait and balance, (2) whether changes in brain activity correlate with changes in behavioral outcomes in older adults and people with age-related neurodegenerative conditions. PubMed, PsycINFO, and Web of Science were searched from 2009 to 2019 using the keywords dual task, brain activity, gait, balance, aging, neurodegeneration, and other related search terms. A total of 15 articles were included in this review. Functional near-infrared spectroscopy and electroencephalogram measures demonstrated that older adults had higher brain activity, particularly in the prefrontal cortex (PFC), compared to young adults during dual task gait and balance. Similar neurophysiological results were observed in people with age-related neurodegenerative conditions. Few studies demonstrated a relationship between increased brain activity and better behavioral outcomes. This systematic review supports the notion that aging and age-related neurodegenerative conditions are associated with neuronal network changes, resulting in increased brain activity specifically in the PFC. Further studies are warranted to assess the relationship between increased PFC activation during dual task gait and balance and behavioral outcomes to better optimize the rehabilitation interventions.
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Affiliation(s)
- Melike Kahya
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Sanghee Moon
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Maud Ranchet
- University of Lyon, IFSTTAR, TS2 LESCOT, Lyon, France.
| | - Rachel R Vukas
- A.R. Dykes Library of the Health Sciences, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Kelly E Lyons
- Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Rajesh Pahwa
- Department of Neurology, School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Abiodun Akinwuntan
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA; Office of the Dean, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Hannes Devos
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA.
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28
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Maidan I, Patashov D, Shustak S, Fahoum F, Gazit E, Shapiro B, Levy A, Sosnik R, Giladi N, Hausdorff JM, Mirelman A. A new approach to quantifying the EEG during walking: Initial evidence of gait related potentials and their changes with aging and dual tasking. Exp Gerontol 2019; 126:110709. [PMID: 31449852 DOI: 10.1016/j.exger.2019.110709] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 08/16/2019] [Accepted: 08/21/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND The electroencephalogram (EEG) can be a useful tool to investigate the neurophysiology of gait during walking. Our aims were to develop an approach that identify and quantify event related potentials (ERPs) during a gait cycle and to examine the effects of aging and dual tasking on these gait related potentials (GRPs). METHODS 10 young and 10 older adults walked on a treadmill while wearing a wireless 20-channels EEG and accelerometers on the ankles. Each heel strike extracted from the accelerometers was used as an event to which the electrical brain activity pattern was locked. The subjects performed usual and dual task walking that included an auditory oddball task. GRPs amplitude and latency were computed, and a new measure referred to as Amplitude Pattern Consistency (APC) was developed to quantify the consistency of these GRP amplitudes within a gait cycle. The results were compared between and within groups using linear mixed model analysis. RESULTS The electrical pattern during a gait cycle consisted of two main positive GRPs. Differences in these GRPs between young and older adults were observed in Pz and Cz. In Pz, older adults had higher GRPs amplitude (p = 0.006, p = 0.010), and in Cz lower APC (p = 0.025). Alterations were also observed between the walking tasks. Both groups showed shorter latency during oddball walking compared to usual walking in Cz (p = 0.040). In addition, the APC in Cz was correlated with gait speed (r = 0.599, p = 0.011) in all subjects and with stride time variability in the older adults (r = -0.703, p = 0.023). CONCLUSIONS This study is the first to define specific gait related potentials within a gait cycle using novel methods for quantifying waveforms. Our findings show the potential of this approach to be applied broadly to study the EEG during gait in a variety of contexts. The observed changes in GRPs with aging and walking task and the relationship between GRPs and gait may suggest the neurophysiologic foundation for studying walking and for developing new approaches for improving gait.
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Affiliation(s)
- I Maidan
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
| | - D Patashov
- Faculty of Engineering, Holon Institute of Technology, Holon, Israel; Faculty of Sciences, Holon Institute of Technology, Holon, Israel
| | - S Shustak
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - F Fahoum
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - E Gazit
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - B Shapiro
- Faculty of Engineering, Holon Institute of Technology, Holon, Israel
| | - A Levy
- Faculty of Engineering, Holon Institute of Technology, Holon, Israel
| | - R Sosnik
- Faculty of Engineering, Holon Institute of Technology, Holon, Israel
| | - N Giladi
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - J M Hausdorff
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - A Mirelman
- Laboratory for Early Markers of Neurodegeneration, Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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29
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Fearon C, Butler JS, Waechter SM, Killane I, Reilly RB, Lynch T. Current source density approaches improve spatial resolution in event related potential analysis in people with Parkinson’s disease. Clin Neurophysiol 2019; 130:1998-1999. [DOI: 10.1016/j.clinph.2019.06.232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 06/04/2019] [Indexed: 11/29/2022]
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30
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Maidan I. Reply to "Current source density approaches improve spatial resolution in event related potential analysis in people with Parkinson's disease". Clin Neurophysiol 2019; 130:2000. [PMID: 31353268 DOI: 10.1016/j.clinph.2019.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 07/12/2019] [Indexed: 11/24/2022]
Affiliation(s)
- Inbal Maidan
- Tel Aviv Medical Center, Neurology, 6 Weitzman Street, Tel Aviv 6203305, Israel.
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