São Paulo State University (UNESP), Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), Rio Claro, Brazil.
Graduate Program in Movement Sciences, São Paulo State University (UNESP), Rio Claro, Brazil.
J Gerontol A Biol Sci Med Sci. 2021 Mar 31;76(4):561-567. doi: 10.1093/gerona/glaa174.
Parkinson's disease (PD) is often classified into tremor dominant (TD) and postural instability gait disorder (PIGD) subtypes. Degeneration of subcortical/cortical pathways is different between PD subtypes, which leads to differences in motor behavior. However, the influence of PD subtype on cortical activity during walking remains poorly understood. Therefore, we aimed to investigate the influence of PD motor subtypes on cortical activity during unobstructed walking and obstacle avoidance. Seventeen PIGD and 19 TD patients performed unobstructed walking and obstacle avoidance conditions. Brain activity was measured using a mobile functional near-infrared spectroscopy-electroencephalography (EEG) systems, and gait parameters were analyzed using an electronic carpet. Concentrations of oxygenated hemoglobin (HbO2) of the prefrontal cortex (PFC) and EEG absolute power from alpha, beta, and gamma bands in FCz, Cz, CPz, and Oz channels were calculated. These EEG channels correspond to supplementary motor area, primary motor cortex, posterior parietal cortex, and visual cortex, respectively. Postural instability gait disorder patients presented higher PFC activity than TD patients, regardless of the walking condition. Tremor dominant patients presented reduced beta power in the Cz channel during obstacle avoidance compared to unobstructed walking. Both TD and PIGD patients decreased alpha and beta power in the FCz and CPz channels. In conclusion, PIGD patients need to recruit additional cognitive resources from the PFC for walking. Both TD and PIGD patients presented changes in the activation of brain areas related to motor/sensorimotor areas in order to maintain balance control during obstacle avoidance, being that TD patients presented further changes in the motor area (Cz channel) to avoid obstacles.
帕金森病（PD）通常分为震颤主导（TD）和姿势不稳步态障碍（PIGD）亚型。PD 亚型之间的皮质下/皮质通路退化不同，这导致运动行为的差异。然而，PD 亚型对步行过程中的皮质活动的影响仍知之甚少。因此，我们旨在研究 PD 运动亚型对无障碍行走和避障期间皮质活动的影响。17 名 PIGD 和 19 名 TD 患者进行了无障碍行走和避障条件下的行走。使用移动近红外光谱-脑电图（EEG）系统测量脑活动，并使用电子地毯分析步态参数。计算前额叶皮层（PFC）的氧合血红蛋白（HbO2）浓度和 FCz、Cz、CPz 和 Oz 通道的 EEG 绝对功率的阿尔法、贝塔和伽马波段。这些 EEG 通道分别对应于辅助运动区、初级运动皮层、顶叶后皮质和视觉皮质。无论行走条件如何，姿势不稳步态障碍患者的 PFC 活动均高于 TD 患者。与无障碍行走相比，震颤主导患者在避障期间 Cz 通道的β功率降低。TD 和 PIGD 患者均降低了 FCz 和 CPz 通道的α和β功率。总之，PIGD 患者需要从 PFC 招募额外的认知资源来进行行走。TD 和 PIGD 患者均改变了与运动/感觉运动区域相关的大脑区域的激活，以在避障期间维持平衡控制，TD 患者在运动区域（Cz 通道）进一步改变以避免障碍物。
