Every-day life means being part of a complex environment and performing complex tasks that usually involve a combination of motor and cognitive skills. However, the process of aging or the sequelae of neurological diseases such as Parkinson's disease (PD) compromises motor-cognitive interaction necessary for an independent lifestyle. While motor-cognitive performance has been identified as an important goal for sustained health across different clinical populations, little is known about underlying brain function leading to these difficulties and how to best target these motor-cognitive difficulties in the context of rehabilitation and exercise interventions. The challenge of improving treatments of motor-cognitive difficulties (such as dual-tasking and navigation) is daunting, and an important step is arriving at a method that accurately portrays these impairments in an ecological valid state. The investigators aim therefore to explore brain function during complex walking in healthy and PD by investigating the effects of age and neurological disease on motor-cognitive performance and its neural correlates during three conditions of complex walking (dual-task walking, navigation and a combination of both) using non-invasive measures of brain activity (functional near infrared spectrometry, fNIRS) and advanced gait analysis in real time in young, older healthy adults and people with PD.
Study Type
OBSERVATIONAL
Enrollment
133
Assessment of brain activity with fNIRS and behavioural assessments (motor, motor-cognitive and cognitive) during three complex walking conditions. 1. Dual-task walking with the auditory stroop task. 2. Navigational walking - a course consisting of a distribution of 45 and 90 degrees turns to the left and right 3. Navigational and dual-task walking (condition 1 and 2 together)
Karolinska institutet
Stockholm, Solna, Sweden
Functional near infrared spectrometry (fNIRS)
The measurement of changes in concentration of HbO and HHb in the prefrontal cortex will be assessed using a NIRSPORT 2 (NIRx Medizintechnik, Berlin, Germany) device
Time frame: During the test session during all three conditions
Gait performance during all conditions
Gait variables such as stride time and/or velocity will be analyzed with the APDM mobility system.
Time frame: During the test session during all three conditions
Dual-task performance-reaction time
Cognitive performance of the dual task will be assessed as errors in the response to the Auditory stroop task.
Time frame: During the test session during dual task conditions
Cognitive function- composite score
The cognitive test battery comprised the following tests: The Color-Word Interference Test (CWIT), Verbal Fluency, Trail Making Test (TMT) and Ray Auditory Verbal Learning Test (RAVLT). Cognitive function will be assessed as a composite measure of these test together.
Time frame: During the test session, takes about 50 minutes
Cognitive function - verbal fluency
Verbal function, initiation \& task-set switching with the Verbal Fluency test from D-KEFS (Delis-Kaplan Executive Function System)
Time frame: During the test session, takes about 12 minutes
Cognitive function - Attention and psychomotor processing speed
Attention and psychomotor processing speed will be assessed with the Trail Making Test (TMT) from D-KEFS (Delis-Kaplan Executive Function System)
Time frame: During the test session, takes about 3 minutes
Cognitive function - Episodic memory
Episodic memory will be assessed with the Ray Auditory Verbal Learning Test (RAVLT).
Time frame: During the test session, takes about 30 minutes
Cognitive function - Inhibition & task-set switching
Inhibition \& task-set switching with the The Color-Word Interference Test (CWIT) from D-KEFS (Delis-Kaplan Executive Function System)
Time frame: During the test session, takes about 5 minutes
Self-reported level of physical activity
Assessed with the Frändin-Grimby Scale (score 1-6, higher score=better)
Time frame: Through study completion, an average of 1 year
Physical activity level and intensity
Assessed with accelerometers (Actigraph GT3X+)
Time frame: For one week after the test session
Motor function/disease severity
Assessed with the movement Disorders Society- Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Higher scores = worse/more symptoms
Time frame: During the test session
Balance performance
Assessed with the Mini-BESTest (Balance Evaluation Systems test), 0-28p,
Time frame: During the test session
Anxiety and depression
Assessed with Hospital Anxiety and Depression Scale (HADS), 0-24 on the depression and anxiety part respectively. Lower score=better
Time frame: Will be answered before the test session in the patients home or during the test session
Walking ability
Self assessed walking ability with the WALK-12G
Time frame: Will be answered before the test session in the patients home or at the test session
Dual-task performance -errors
Cognitive performance of the dual task will be assessed as the reaction time to respond during Auditory stroop
Time frame: During the test session during dual task conditions
Disability
WHO Disability Assessment Schedule (WHODAS) version 2.0, 12 self-assessed questions (12 to 60) more points=worse
Time frame: Will be answered before the test session in the patients home or during the test session
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