Gait and risk of falls associated with frontal cognitive functions at different stages of Alzheimer's disease

Coelho, Flávia Gomes de Melo; Stella, Florindo; Andrade, Larissa Pires de; Barbieri, Fábio Augusto; Santos-Galduróz, Ruth Ferreira; Gobbi, Sebastião; Costa, José Luiz Riani; Gobbi, Lílian Teresa Bucken

doi:10.1080/13825585.2012.661398

Cited by 58 publications

(37 citation statements)

References 30 publications

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“…Impairments in gait and posture control are risk factors for falls in the elderly and in PD patients (Bridenbaugh and Kressig, 2011; Coelho et al, 2012; Granacher et al, 2011; Uemura et al, 2011; for review see Ayers et al, 2013; Gepshtein et al, 2014; Montero-Odasso et al, 2012a,b). Our evidence from the animal model supports the hypothesis that striatal dopaminergic decline is a contributor to the manifestation of these risk factors.…”

Section: Risk Factors For Falls Resulting From Striatal Dopamine Declinementioning

confidence: 99%

Where attention falls: Increased risk of falls from the converging impact of cortical cholinergic and midbrain dopamine loss on striatal function

Sarter

Albin

Kucinski

et al. 2014

Experimental Neurology

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Falls are a major source of hospitalization, long-term institutionalization, and death in older adults and patients with Parkinson’s disease (PD). Limited attentional resources are a major risk factor for falls. In this review, we specify cognitive–behavioral mechanisms that produce falls and map these mechanisms onto a model of multi-system degeneration. Results from PET studies in PD fallers and findings from a recently developed animal model support the hypothesis that falls result from interactions between loss of basal forebrain cholinergic projections to the cortex and striatal dopamine loss. Striatal dopamine loss produces inefficient, low-vigor gait, posture control, and movement. Cortical cholinergic deafferentation impairs a wide range of attentional processes, including monitoring of gait, posture and complex movements. Cholinergic cell loss reveals the full impact of striatal dopamine loss on motor performance, reflecting loss of compensatory attentional supervision of movement. Dysregulation of dorsomedial striatal circuitry is an essential, albeit not exclusive, mediator of falls in this dual-system model. Because cholinergic neuromodulatory activity influences cortical circuitry primarily via stimulation of α4β2* nicotinic acetylcholine receptors, and because agonists at these receptors are known to benefit attentional processes in animals and humans, treating PD fallers with such agonists, as an adjunct to dopaminergic treatment, is predicted to reduce falls. Falls are an informative behavioral endpoint to study attentional–motor integration by striatal circuitry.

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Section: Risk Factors For Falls Resulting From Striatal Dopamine Declinementioning

confidence: 99%

Where attention falls: Increased risk of falls from the converging impact of cortical cholinergic and midbrain dopamine loss on striatal function

Sarter

Albin

Kucinski

et al. 2014

Experimental Neurology

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“…Recent related research has highlighted that impaired gait, measured as walking speed, is associated with both progression to dementia and increased mortality [33-35]. Thus having identified a possible physical substrate and component of frontostriatal circuits implicated in cortical control of gait and balance is a significant advance.…”

Section: Resultsmentioning

confidence: 99%

“…Our chief hypothesis was that we would detect shape deflation in striatal regions corresponding to areas of the motor cortex, and that this deflation would correlate with poorer performance on the Short Physical Performance Battery. Gait, measured via walking speed in the SPPB, has been associated with cognitive impairment and progression to dementia [33-35]. We further hypothesised that striatal morphology would be associated with walking speed.…”

Section: Introductionmentioning

confidence: 99%

Shape Abnormalities of the Caudate Nucleus Correlate with Poorer Gait and Balance: Results from a Subset of the LADIS Study

Macfarlane

Looi

Walterfang

et al. 2015

The American Journal of Geriatric Psychiatry

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Objective Functional deficits seen in several neurodegenerative disorders have been linked with dysfunction in fronto-striatal circuits and with associated shape alterations in striatal structures. The severity of visible white matter changes (WMC) on MRI has been found to correlate with poorer performance on measures of gait and balance. This study aimed to determine whether striatal volume and shape changes were correlated with gait dysfunction. Method MRI scans and clinical gait/balance data (scores from the SPPB - Short Physical Performance Battery) were sourced from 66 subjects in the previously-published LADIS trial, which was performed in >65 y.o. non-disabled individuals with WMC at study entry. Data were obtained at study entry and at three-year follow-up. Caudate nuclei and putamina were manually traced using a previously published method, and volumes calculated. The relationships between volume and physical performance on the SPPB were investigated with shape analysis utilising the SPHARM toolkit. Results There was no correlation between the severity of WMC and striatal volumes. Caudate nuclei volume correlated with performance on the SPPB at baseline, but not at follow-up, with subsequent shape analysis showing regionalisation of left caudate changes in areas corresponding to inputs of the dorsolateral prefrontal, premotor and motor cortex. There was no correlation between putamen volumes and performance on the SPPB. Conclusion Disruption in frontostriatal circuits may play a role in mediating poorer physical performance in individuals with white matter changes. Striatal volume and shape changes may be suitable biomarkers for functional changes in this population.

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“…Moreover, studies show that impairments in physical function are most evident when patients are engaged in dual-task (DT) performance, which requires an ability to do a motor task and a cognitive task simultaneously (Bruce-Keller et al, 2012;Cedervall, Halvorsen, & Aberg, 2014;Ijmker & Lamoth, 2012;Muir et al, 2012). However, the strength of the associations between DT performance and cognition in patients with AD is still unclear (Bruce-Keller et al, 2012;Coelho et al, 2012;Ijmker & Lamoth, 2012;Sheridan et al, 2003).…”

Section: Introductionmentioning

confidence: 98%

Associations between physical function, dual-task performance and cognition in patients with mild Alzheimer's disease

Sobol

Hoffmann

Vogel

et al. 2015

Aging & Mental Health

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Gait and risk of falls associated with frontal cognitive functions at different stages of Alzheimer's disease

Cited by 58 publications

References 30 publications

Where attention falls: Increased risk of falls from the converging impact of cortical cholinergic and midbrain dopamine loss on striatal function

Where attention falls: Increased risk of falls from the converging impact of cortical cholinergic and midbrain dopamine loss on striatal function

Shape Abnormalities of the Caudate Nucleus Correlate with Poorer Gait and Balance: Results from a Subset of the LADIS Study

Associations between physical function, dual-task performance and cognition in patients with mild Alzheimer's disease

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