Between-sessions test-retest reliability of prefrontal cortical activity during usual walking in patients with Parkinson's Disease: A fNIRS study.

BACKGROUND: Examining between-sessions test-retest reliability of functional near-infrared spectroscopy (fNIRS) data is crucial to better interpret rehabilitation-related changes in the hemodynamic response. RESEARCH QUESTION: This study investigated test-retest reliability of prefrontal activity during usual walking in 14 patients with Parkinson's Disease with a fixed retest intervals of five weeks. METHODS: Fourteen patients performed usual walking in two sessions (T0 and T1). Relative changes in cortical activity (oxy and deoxyhemoglobin: ∆HbO2 and ∆HbR, respectively) in the dorsolateral prefrontal cortex (DLPFC) using fNIRS system and gait performance were measured. Test-retest reliability of mean ∆HbO2 for the total DLPFC and for each hemisphere were measured using paired t-test, intraclass correlation coefficient (ICC), and Bland-Altman plots with 95% agreement. Pearson correlations between cortical activity and gait performance were also performed. RESULTS: Moderate reliability was found for ∆HbO2 in the total DLPFC (mean difference of ∆HbO2 between T1 and T0 = -0.005 µmol, p = 0.93; ICC average = 0.72). However, test-retest reliability of ∆HbO2 was poorer when considering each hemisphere. SIGNIFICANCE: Findings suggest that fNIRS may be used as a reliable tool for rehabilitation studies in patients with PD. Test-retest reliability of fNIRS data between 2 sessions during walking tasks should be interpreted respectively of gait performance.

An intensive exercise-based training program reduces prefrontal activity during usual walking in patients with Parkinson's disease.

INTRODUCTION: Parkinson's disease (PD) leads to a progressive loss of locomotor automaticity. Consequently, PD patients rely more on executive resources for the control of gait, resulting in increased prefrontal activity while walking. Exercise-based training programs may improve automaticity of walking and reduce prefrontal activity in this population. This study aimed to assess the effect of an intensive multidisciplinary exercise-based training program on prefrontal activity and gait performance during usual walking in PD patients. METHOD: Fourteen patients (mean age: 67 ± 9; disease duration: 6 ± 5 years; Hoehn and Yahr score: 1.9 ± 0.6) were included in this study. They were assessed in ON stage at three different times at 5-week intervals: two times before the training program (T0 and T1) and once after the training program (T2). Gait performance (stride time, speed, stride length, cadence, and their respective coefficient of variation) and cortical activity in the dorsolateral prefrontal cortex (DLPFC) using functional near infrared spectroscopy (fNIRS) were measured during usual walking. RESULTS: Patients had reduced cortical activity of the DLPFC at T2 compared to T1 (p = 0.003). Patients had shorter stride time at T2 compared to T1 (p = 0.025) and tended to have longer stride length at T2 than at T1 (p = 0.056). CONCLUSION: The training program led to positive effects on prefrontal activity and gait performance. Reduced prefrontal activity during usual walking after training program suggests that patients may have a greater reserve capacity to face more challenging walking conditions. Further studies will investigate the effect of this training on cortical activity during dual-task walking..

Increased prefrontal activity during usual walking in aging.

Executive functions are important for successful accomplishment of walking tasks, particularly during a dual task. Over the past few years, several studies investigated prefrontal cortex activity under different walking conditions in older adults with functional near infrared spectroscopy (fNIRS). However, little is known about changes in dorsolateral prefrontal cortex (DLPFC) activity during walking in the early stages of aging. The main objective of this study was to compare changes in DLPFC activity during simple and dual task walking across three different age groups. Twenty-five young (age range = 18-37), twenty-five youngest-old (age range = 55-65), and twenty-five older adults (age range = 67-87) participated in this study. Main results showed that, during simple task walking, older adults had increased DLPFC activity with equivalent walking performance. This increased mainly concerned the right hemisphere. During dual task walking, older adults had increased right DLPFC activity but seemed to have enough resources to maintain their performance during DT walking. This result supports the idea that compensation mechanisms, due to loss of automaticity of walking in aging, appear already during simple task walking. Measuring cortical activity with fNIRS during a simple task walking might be used as valuable indicator for identifying individuals at risk of falling.