Changes in metabolic activity and gait function by dual-task cognitive game-based treadmill system intervention
University of Manitoba
Parkinson’s disease is a neurodegenerative disorder that affects approximately 100,000 Canadians. Poor balance and consequently mobility restrictions and falls are common in Parkinson’s disease. Various forms of cognitive dysfunction are also common in Parkinson’s disease and they are associated with increased fall risk. Deficits in mobility and cognitive function are serious problems that many people with Parkinson’s disease face in their day-to-day lives, and are limiting factors in a person’s
health, ability to perform activities of daily living, and overall quality of life.
Community ambulation involves many dual-task conditions that require processing of several cognitive tasks while managing or reacting to sudden or unexpected balance challenges. Consequently, dual- task (DT) training programs that can simultaneously target balance-gait function and cognition are important to consider in rehabilitation and promotion of healthy active lives. However the neural underpinnings of gait impairment as well as the clinical benefit of dual-task training are poorly understood.
In the proposed multi-center study, novel behavioral brain imaging methods will be used to evaluate the molecular basis and neural underpinnings of: (a) the decline of mobility function in Parkinson’s disease, specifically, balance, gait and cognitive function, and (b) the effects of our game-assisted dual-task walking program on mobility functions.
Relevance to the acceleration of therapeutics for neurodegenerative diseases of aging
Improved mobility functioning in Parkinson’s disease (gait and cognition) directly translates to improved community ambulation, level of physical activity, and social participation. These benefits are known to have a significant preventive and diseasemodifying impact. While the focus of the present proposal is on the study of brain-behavior relationships and neuroplasticity mechanisms in Parkinson’s disease, our dual-task mobility-training platform and behavioral PET brain imaging methods is directly applicable to other diseases that affect gait and cognition, e.g., cognitive vascular impairment, Alzheimer’s disease, and ageing. The neurophysiological validation using brain imaging will expediate further improvement and optimization of the proposed rehabilitation technology platform.
The proposed study results will provide neural evidence of brain plasticity and support dual-task walking training in Parkinson’s disease. Both the interactive cognitive game tasks and treadmill walking requires continuous visual attention, and share other brain processing functions critical to realize and correct sudden loss of balance and stumbles. The ability to “walk and talk” normally includes activation of specific regions of the prefrontal cortex and the basal ganglia (site of degeneration in Parkinson’s disease). The behavioral brain imaging analysis and comparison with healthy age-match controls will allow us to identify areas of abnormal, reduced activity levels as well as areas of excessive activity (increased attentional resources ) during walking. We will then be able to identify areas of brain plasticity associated with improvements in mobility functions (balance, gait and cognition). We expect the gait – cognitive training effect to involve re-organization of prefrontal cortex activity and likely other brain regions yet to be identified.