(A)symmetry during gait initiation in people with Parkinson's disease: A motor and cortical activity exploratory study

Author(s)

Faria, Murilo Henrique ; Simieli, Lucas ; Rietdyk, Shirley ; Penedo, Tiago ; Santinelli, Felipe Balistieri ; Barbieri, Fabio Augusto

• Document type: Journal article
• Source: FRONTIERS IN AGING NEUROSCIENCE; v. 15, p. 11-pg., 2023-04-17.

Abstract

BackgroundGait asymmetry and deficits in gait initiation (GI) are among the most disabling symptoms in people with Parkinson's disease (PwPD). Understanding if PwPD with reduced asymmetry during GI have higher asymmetry in cortical activity may provide support for an adaptive mechanism to improve GI, particularly in the presence of an obstacle. ObjectiveThis study quantified the asymmetry of anticipatory postural adjustments (APAs), stepping parameters and cortical activity during GI, and tested if the presence of an obstacle regulates asymmetry in PwPD. MethodsSixteen PwPD and 16 control group (CG) performed 20-trials in two conditions: unobstructed and obstructed GI with right and left limbs. We measured, through symmetry index, (i) motor parameters: APAs and stepping, and (ii) cortical activity: the PSD of the frontal, sensorimotor and occipital areas during APA, STEP-I (moment of heel-off of the leading foot in the GI until the heel contact of the same foot); and STEP-II (moment of the heel-off of the trailing foot in the GI until the heel contact of the same foot) phases. ResultsParkinson's disease showed higher asymmetry in cortical activity during APA, STEP-I and STEP-II phases and step velocity (STEP-II phase) during unobstructed GI than CG. However, unexpectedly, PwPD reduced the level of asymmetry of anterior-posterior displacement (p < 0.01) and medial-lateral velocity (p < 0.05) of the APAs. Also, when an obstacle was in place, PwPD showed higher APAs asymmetry (medial-lateral velocity: p < 0.002), with reduced and increased asymmetry of the cortical activity during APA and STEP-I phases, respectively. ConclusionParkinson's disease were not motor asymmetric during GI, indicating that higher cortical activity asymmetry can be interpreted as an adaptive behavior to reduce motor asymmetry. In addition, the presence of obstacle did not regulate motor asymmetry during GI in PwPD. (AU)

• FAPESP's process: 18/21870-7 - The impact of the asymmetry on cortical activity during gait initiation with and without obstacle avoidance in people with Parkinson's Disease
• Grantee: Murilo Henrique Faria
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• FAPESP's process: 22/02971-2 - Unrevealing the gait asymmetry in patients with Parkinson’s Disease: from the neural and motor mechanisms to rehabilitation: AsymmGait-Parkinson study
• Grantee: Fabio Augusto Barbieri
• Support Opportunities: Research Grants - Initial Project
• FAPESP's process: 19/24752-8 - Joint moment during gait initiation in people with Parkinson's Disease
• Grantee: Murilo Henrique Faria
• Support Opportunities: Scholarships abroad - Research Internship - Scientific Initiation