Single- and dual-task gait performance and their diagnostic value in early-stage Parkinson's disease

Zhang, Xiaodan; Fan, Weinv; Yu, Hao; Li, Li; Chen, Zhaoying; Guan, Qiongfeng

doi:10.3389/fneur.2022.974985

Cited by 5 publications

(6 citation statements)

References 69 publications

(105 reference statements)

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“…To delve deeper into the relationship between the cholinergic system and gait performance in PD, we employed sensor-based gait analysis, which offers more objective and quantitative gait parameters for capturing subtle gait changes and enhancing sensitivity for early symptom detection and tracking [ 15 , 18 ]. Our findings contribute additional evidence to emphasize the intricate associations between Ch123/Ch4 degeneration and the pace, rhythm, variability, and ROM domain of gait in PD patients.…”

Section: Discussionmentioning

confidence: 99%

“…Gait parameters were collected using the JiBuEn ® system, as depicted in Fig. 1 a [ 15 , 18 ]. Participants performed two tests at their self-selected pace:…”

Section: Methodsmentioning

confidence: 99%

“…Methods to collect gait parameters have been described in our previous study [ 15 ]. Gait parameters were obtained from each 10-meter walking test, encompassing both spatiotemporal and kinematic parameters, as shown in Fig.…”

Section: Methodsmentioning

confidence: 99%

“…The comprehensive gait characteristics include spatiotemporal and kinematic parameters, variability, and symmetry of gait in both single-task (ST) and dual-task (DT) walking. Our previous study suggested that PD patients exhibited a slower GV, a shorter stride length (SL), a shorter swing time, a smaller toe-off (TO) and heel-strike (HS) angles compared with controls in both ST and DT walking [ 15 ]. Therefore, it is crucial to investigate the association between cholinergic dysfunction and comprehensive gait parameters to identify new therapeutic approaches for gait dysfunction in PD.…”

Section: Introductionmentioning

confidence: 99%

“…The development of wearable gait analysis and neuroimaging technologies have facilitated the understanding of gait disturbance in PD. Sensor-based gait analysis can capture the kinematics and dynamics of gait, thus provide comprehensive quantitative gait parameters [ 15 ]. Brain structural analysis of magnetic resonance imaging (MRI) technology enables comprehensive assessment of the morphological features of cBF, encompassing the gray matter density (GMD) and volumes (GMV) for bilateral Ch123 and Ch4 [ 1 , 4 , 7 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Cholinergic nucleus degeneration and its association with gait impairment in Parkinson’s disease

Zhang,

Wang,

Lee

et al. 2024

J NeuroEngineering Rehabil

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Background The contribution of cholinergic degeneration to gait disturbance in Parkinson’s disease (PD) is increasingly recognized, yet its relationship with dopaminergic-resistant gait parameters has been poorly investigated. We investigated the association between comprehensive gait parameters and cholinergic nucleus degeneration in PD. Methods This cross-sectional study enrolled 84 PD patients and 69 controls. All subjects underwent brain structural magnetic resonance imaging to assess the gray matter density (GMD) and volume (GMV) of the cholinergic nuclei (Ch123/Ch4). Gait parameters under single-task (ST) and dual-task (DT) walking tests were acquired using sensor wearables in PD group. We compared cholinergic nucleus morphology and gait performance between groups and examined their association. Results PD patients exhibited significantly decreased GMD and GMV of the left Ch4 compared to controls after reaching HY stage > 2. Significant correlations were observed between multiple gait parameters and bilateral Ch123/Ch4. After multiple testing correction, the Ch123/Ch4 degeneration was significantly associated with shorter stride length, lower gait velocity, longer stance phase, smaller ankle toe-off and heel-strike angles under both ST and DT condition. For PD patients with HY stage 1–2, there were no significant degeneration of Ch123/4, and only right side Ch123/Ch4 were corrected with the gait parameters. However, as the disease progressed to HY stage > 2, bilateral Ch123/Ch4 nuclei showed correlations with gait performance, with more extensive significant correlations were observed in the right side. Conclusions Our study demonstrated the progressive association between cholinergic nuclei degeneration and gait impairment across different stages of PD, and highlighting the potential lateralization of the cholinergic nuclei’s impact on gait impairment. These findings offer insights for the design and implementation of future clinical trials investigating cholinergic treatments as a promising approach to address gait impairments in PD.

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Section: Discussionmentioning

confidence: 99%

“…Gait parameters were collected using the JiBuEn ® system, as depicted in Fig. 1 a [ 15 , 18 ]. Participants performed two tests at their self-selected pace:…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Cholinergic nucleus degeneration and its association with gait impairment in Parkinson’s disease

Zhang,

Wang,

Lee

et al. 2024

J NeuroEngineering Rehabil

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Impaired dual-task gait in Parkinson’s disease is associated with brain morphology changes

Krupička,

Malá,

Neťuková

et al. 2024

J Neural Transm

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In Parkinson’s disease (PD), impaired gait and cognition affect daily activities, particularly in the more advanced stages of the disease. This study investigated the relationship between gait parameters, cognitive performance, and brain morphology in patients with early untreated PD. 64 drug-naive PD patients and 47 healthy controls (HC) participated in the study. Single- and dual-task gait (counting task) were examined using an expanded Timed Up & Go Test measured on a GaitRite walkway. Measurements included gait speed, stride length, and cadence. A brain morphometry analysis was performed on T1-weighted magnetic resonance (MR) images. In PD patients compared to HC, gait analysis revealed reduced speed (p < 0.001) and stride length (p < 0.001) in single-task gait, as well as greater dual-task cost (DTC) for speed (p = 0.007), stride length (p = 0.014) and cadence (p = 0.029). Based on the DTC measures in HC, PD patients were further divided into two subgroups with normal DTC (PD-nDTC) and abnormally increased DTC (PD-iDTC). For PD-nDTC, voxel-based morphometric correlation analysis revealed a positive correlation between a cluster in the left primary motor cortex and stride-length DTC (r = 0.57, p = 0.027). For PD-iDTC, a negative correlation was found between a cluster in the right lingual gyrus and the DTC for gait cadence (r=-0.35, pFWE = 0.018). No significant correlations were found in HC. The associations found between brain morphometry and gait performance with a concurrent cognitive task may represent the substrate for gait and cognitive impairment occurring since the early stages of PD.

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The impact of anxiety on gait impairments in Parkinson’s disease: insights from sensor-based gait analysis

Zhang,

Jin,

Wang

et al. 2024

J NeuroEngineering Rehabil

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Background Sensor-based gait analysis provides a robust quantitative tool for assessing gait impairments and their associated factors in Parkinson’s disease (PD). Anxiety is observed to interfere with gait clinically, but this has been poorly investigated. Our purpose is to utilize gait analysis to uncover the effect of anxiety on gait in patients with PD. Methods We enrolled 38 and 106 PD patients with and without anxiety, respectively. Gait parameters were quantitively examined and compared between two groups both in single-task (ST) and dual-task (DT) walking tests. Multiple linear regression was applied to evaluate whether anxiety independently contributed to gait impairments. Results During ST, PD patients with anxiety presented significantly shorter stride length, lower gait velocity, longer stride time and stance time, longer stance phase, smaller toe-off (TO) and heel-strike (HS) angles than those without anxiety. While under DT status, the differences were diminished. Multiple linear regression analysis demonstrated that anxiety was an independent factor to a serials of gait parameters, particularly ST-TO (B = -2.599, (-4.82, -0.38)), ST-HS (B = -2.532, (-4.71, -0.35)), ST-TO-CV (B = 4.627, (1.71, 7.64)), ST-HS-CV(B = 4.597, (1.66, 7.53)), ST stance phase (B = 1.4, (0.22, 2.58)), and DT stance phase (B = 1.749, (0.56, 2.94)). Conclusion Our study discovered that anxiety has a significant impact on gait impairments in PD patients, especially exacerbating shuffling steps and prolonging stance phase. These findings highlight the importance of addressing anxiety in PD precision therapy to achieve better treatment outcomes.

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Single- and dual-task gait performance and their diagnostic value in early-stage Parkinson's disease

Cited by 5 publications

References 69 publications

Cholinergic nucleus degeneration and its association with gait impairment in Parkinson’s disease

Cholinergic nucleus degeneration and its association with gait impairment in Parkinson’s disease

Impaired dual-task gait in Parkinson’s disease is associated with brain morphology changes

The impact of anxiety on gait impairments in Parkinson’s disease: insights from sensor-based gait analysis

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