Attentional set-shifting deficits correlate with the severity of freezing of gait in Parkinson's disease

Shine, James M.; Naismith, Sharon L.; Palavra, Natalie C; Lewis, Simon J.G.; Moore, Steven T.; Dilda, Valentina; Morris, Tiffany R.

doi:10.1016/j.parkreldis.2012.07.015

Cited by 57 publications

(39 citation statements)

References 5 publications

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“…In view of the literature data [15][16][17][18][19], we could have expected to see extensive attentional failure in patients with FoG (caused by an increase in attentional cost as the task increased in complexity). In such a case, the RTs should have lengthened progressively from the simple RT to the go/no go choice RT, the focused-attention choice RT (with distractor inhibition), the divided-attention choice RT (with a need to take account of two attributes) and, lastly, the alternating choice RT.…”

Section: Discussionmentioning

confidence: 97%

“…In particular, it is necessary to precisely determine the role of cognition in this gait disorder, with a view to better understanding the neural substrates and improving rehabilitation [13]. In this regard, different aspects of attention have been explored: regulation of external factors [14], orienting [15], focusing [16], set-shifting [16][17][18], conflict resolution [19], error monitoring [20] and maintaining/disengaging attention [21]. Nevertheless, the specific nature of impairments in the various attentional components has not been systematically assessed in PD patients with FoG, previous studies investigating either a specific component either using more complex tasks involving executive functions.…”

Section: Introductionmentioning

confidence: 99%

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Specific Attentional Disorders and Freezing of Gait in Parkinson’s Disease

Tard

Delval

Duhamel

et al. 2015

JPD

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Background: Due to its high prevalence in dual-task paradigms, freezing of gait in Parkinson's disease is thought to be associated with dysexecutive syndrome and attentional disorders. However, the role of specific attentional disorders in patients with freezing of gait is still unclear. Objective: Here, we sought to specifically determine which basic attentional modalities are impaired in patients with freezing of gait. Methods: Seventy-eight parkinsonian patients performed a computer-controlled reaction-time paradigm designed to measure the different attentional subcomponents, controlled for visuospatial processing and motor participation. Results: The freezer (n = 42) and non-freezer (n = 36) groups were matched for age, educational level, MMSE and Mattis Dementia Rating Scale. There were no intergroup differences in simple reaction times, whereas choice reaction times were higher in the freezer group than in the non-freezer group for divided attention (p = 0.023). Conclusions: At equivalent levels of overall cognitive efficiency, freezer patients showed a greater slowdown than non-freezer patients with a specific impairment in divided attention.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Specific Attentional Disorders and Freezing of Gait in Parkinson’s Disease

Tard

Delval

Duhamel

et al. 2015

JPD

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“…In another study, freezers also experienced set-shifting difficulties under temporal pressure, as measured by the Trail-Making-Test (Naismith et al, 2010). These differences also correlate with severity of FOG (Shine et al, 2012). …”

Section: Controlled Processes and Fogmentioning

confidence: 96%

Freezing of gait in Parkinson's disease: disturbances in automaticity and control

Vandenbossche¹,

Deroost²,

Soetens³

et al. 2013

Front. Hum. Neurosci.

130

140

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Recent studies emphasize a key role of controlled operations, such as set-shifting and inhibition, in the occurrence of freezing of gait (FOG) in Parkinson's disease (PD). However, FOG can also be characterized as a de-automatization disorder, showing impairments in both the execution and acquisition of automaticity. The observed deficits in automaticity and executive functioning indicate that both processes are malfunctioning in freezers. Therefore, to explain FOG from a cognitive-based perspective, we present a model describing the pathways involved in automatic and controlled processes prior to a FOG episode. Crucially, we focus on disturbances in automaticity and control, regulated by the frontostriatal circuitry. In complex situations, non-freezing PD patients may compensate for deficits in automaticity by switching to increased cognitive control. However, as both automatic and controlled processes are more severely impaired in freezers, this hampers cognitive compensation in FOG, resulting in a potential breakdown. Future directions for cognitive rehabilitation are proposed, based on the cognitive model we put forward.

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“…First, participants were not used to walking with smart glasses, and this novel experience, together with their experience of the smart glasses being quite heavy and uncomfortable, might have caused distractions. It is well recognized that dividing attention is impaired in PD-FOG (36), and FOG severity has been correlated with difficulties in switching attention (37). Dual tasks, which also require switching or dividing attention, are known to deteriorate FOG (38) and to counteract the FOG-alleviating effects of visual cues (39).…”

Section: Discussionmentioning

confidence: 99%

Usability of Three-dimensional Augmented Visual Cues Delivered by Smart Glasses on (Freezing of) Gait in Parkinson’s Disease

et al. 2017

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External cueing is a potentially effective strategy to reduce freezing of gait (FOG) in persons with Parkinson’s disease (PD). Case reports suggest that three-dimensional (3D) cues might be more effective in reducing FOG than two-dimensional cues. We investigate the usability of 3D augmented reality visual cues delivered by smart glasses in comparison to conventional 3D transverse bars on the floor and auditory cueing via a metronome in reducing FOG and improving gait parameters. In laboratory experiments, 25 persons with PD and FOG performed walking tasks while wearing custom-made smart glasses under five conditions, at the end-of-dose. For two conditions, augmented visual cues (bars/staircase) were displayed via the smart glasses. The control conditions involved conventional 3D transverse bars on the floor, auditory cueing via a metronome, and no cueing. The number of FOG episodes and percentage of time spent on FOG were rated from video recordings. The stride length and its variability, cycle time and its variability, cadence, and speed were calculated from motion data collected with a motion capture suit equipped with 17 inertial measurement units. A total of 300 FOG episodes occurred in 19 out of 25 participants. There were no statistically significant differences in number of FOG episodes and percentage of time spent on FOG across the five conditions. The conventional bars increased stride length, cycle time, and stride length variability, while decreasing cadence and speed. No effects for the other conditions were found. Participants preferred the metronome most, and the augmented staircase least. They suggested to improve the comfort, esthetics, usability, field of view, and stability of the smart glasses on the head and to reduce their weight and size. In their current form, augmented visual cues delivered by smart glasses are not beneficial for persons with PD and FOG. This could be attributable to distraction, blockage of visual feedback, insufficient familiarization with the smart glasses, or display of the visual cues in the central rather than peripheral visual field. Future smart glasses are required to be more lightweight, comfortable, and user friendly to avoid distraction and blockage of sensory feedback, thus increasing usability.

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Attentional set-shifting deficits correlate with the severity of freezing of gait in Parkinson's disease

Cited by 57 publications

References 5 publications

Specific Attentional Disorders and Freezing of Gait in Parkinson’s Disease

Specific Attentional Disorders and Freezing of Gait in Parkinson’s Disease

Freezing of gait in Parkinson's disease: disturbances in automaticity and control

Usability of Three-dimensional Augmented Visual Cues Delivered by Smart Glasses on (Freezing of) Gait in Parkinson’s Disease

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