Combining a Cognitive Concurrent Task with a Motor or Motor-Cognitive Task: Which Is Better to Differentiate Levels of Affectation in Parkinson’s Disease?

Abstract

Introduction. Cognitive decline usually coexists with motor impairment in PD. Multitask settings provide appropriate measures to evaluate the complex interaction between motor and cognitive impairments. The main objective was to analyze which concurrent task, i. e., motor or hybrid motor-cognitive, in combination with a cognitive task better differentiates between PD patients with mild and moderate levels of disease. Methods. Thirty-seven individuals (19 male and 18 female) with idiopathic PD performed dual and triple tasks combining a cognitive task (phonemic fluency) with motor (pedaling) and/or cognitive-motor hybrid (tracking) tasks. Mild and moderate disability PD groups were specified considering the Hoehn and Yahr scale. Mixed ANOVA analyses for each of the concurrent task were carried out to test differences between the single and dual or triple condition performances comparing the low and high PD disability groups. Supplementary mixed ANCOVA analysis was performed considering the cognitive status as the covariate. Results. The only significant differences between disability PD groups were found for performances in the cognitive-motor hybrid (tracking) task, both in dual and triple conditions. Our results showed a better performance for the mild rather than for the moderate disability group in the single condition task and a significant decline of the mild disability group in the dual and triple condition when compared to the levels of those shown by the moderate disability group. The group-condition interaction remained significant when the cognitive status was statistically controlled. Conclusion. The hybrid of motor-cognitive task combining with a cognitive task (i. e., fluency) successfully differentiated between mild and moderate PD patients in the context of dual and triple multitask sets even when the cognitive status was statistically controlled. Our results highlight the importance of jointly measuring the complex interplay between motor and cognitive skills in PD.

Dual-task performance in old adults: cognitive, functional, psychosocial and socio-demographic variables

“…Accordingly, performance in the purely cognitive task (Fluency) in the dual condition was directly influenced by cognitive factors, whereas performance of the cognitive–motor task (which includes tracking, involving following a series of points on a sheet of paper) in the dual condition was more broadly influenced by psychosocial and health factors and age. These results can be interpreted in accordance with those of Pereiro et al [ 42 ], who concluded that the demands involved in hybrid cognitive–motor tasks are better for differentiating levels of disability or frailty.…”

Reverse Visually Guided Reaching in Patients with Parkinson’s Disease

“…The main finding is that the use of a visuo-motor transformation in a reaching movement better detects the effect of DRT, DBS, and DBS + DRT in comparison with habitual reaching movements. This is consistent with previous findings showing that the addition of a cognitive load to a motor task has greater sensitivity in differentiating mild and moderate disability in PD [ 63 ]. Patients with PD may also have a slower movement speed when external cues are reduced [ 64 ] or to unanticipated external visual targets [ 62 ].…”