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

Autor(es)

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

• Tipo de documento: Artigo Científico
• Fonte: FRONTIERS IN AGING NEUROSCIENCE; v. 15, p. 11-pg., 2023-04-17.

Resumo

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)

• Processo FAPESP: 18/21870-7 - O impacto da assimetria na atividade cortical durante o início do andar com e sem presença de obstáculo em pessoas com Doença de Parkinson
• Beneficiário: Murilo Henrique Faria
• Modalidade de apoio: Bolsas no Brasil - Iniciação Científica
• Processo FAPESP: 22/02971-2 - Desvendando a assimetria do andar em pacientes com Doença de Parkinson: dos mecanismos neurais e motores à reabilitação: AsymmGait-Parkinson study
• Beneficiário: Fabio Augusto Barbieri
• Modalidade de apoio: Auxílio à Pesquisa - Projeto Inicial
• Processo FAPESP: 19/24752-8 - Momento articular durante a iniciação da marcha em pessoas com Doença de Parkinson
• Beneficiário: Murilo Henrique Faria
• Modalidade de apoio: Bolsas no Exterior - Estágio de Pesquisa - Iniciação Científica