Cognition, vision and visuo-cognition in gait in Parkinson’s disease Stuart S, Galna B, Lord S, and Rochester L Institute of Neuroscience/Newcastle University Institute of Ageing, Newcastle University http://research.ncl.ac.uk/hmst |
@BAM_Research |
Introduction
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[email protected]
Methods
• Gait impairment is a core feature of Parkinson’s disease (PD) with implications for falls risk and is difficult to treat due to its multi-factorial nature. • Impairment has been linked to cognitive and visual deficits through separate strands of research [1]. • Cognition and vision however are interrelated (termed visuo-cognition) confounding understanding of their roles. • Their separate and combined influence on gait is key to understanding gait deficits, potential falls risk and develop targeted therapeutics.
• A Dikablis mobile eye-tracker measured saccade frequency (number of fast eye movements per second; a proxy for visuo-cognition [1,2]) during gait in 56 people with PD and 40 age-matched older adults (≥50 years) (controls) [3,4]. • Clinical, cognitive and visual assessments were performed. • Participants walked under varied environmental (Fig 1) and attentional demand (dual-task) [3]. • Saccade frequency was reported as well as change in saccade frequency between conditions (Δ) (i.e. ΔTurn = Turn – Straight, or ΔDoor = Door – Straight). • Effect of environmental and attentional demand were assessed using repeat measures ANOVAs. Relationships between saccade frequency, vision, cognition, and gait were explored using structural equation modelling (SEM). Straight walk
Aims:
Straight walk through a door
40° turn
40° turn starting 10° off centre
1) Examine saccade frequency during gait in PD in response to environmental and attentional demand (dual task) 2) Examine the relationship between visual function, cognition, saccade frequency and gait in PD.
2.5m
0.8m
Results • • • • • •
Fig 1 Walking Conditions
PD participants had significantly impaired cognition and vision compared to controls (Table 1) PD participants took significantly longer than controls to complete the walks (p=.009) PD participants made fewer saccades (p=.002) than controls during all of the walks, particularly with increased attentional demand (dual task) (Fig 2) Saccade frequency significantly increased with environmental (p
