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帕金森病双重任务步态表现中的认知储备和执行功能。

Cognitive reserve and executive functions in dual task gait performance in Parkinson's disease.

机构信息

Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.

Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation, IRBLleida, Lleida, Spain.

出版信息

Exp Brain Res. 2024 Sep;242(9):2271-2278. doi: 10.1007/s00221-024-06897-6. Epub 2024 Jul 25.

Abstract

A higher level of education was correlated with less severe motor impairment in Parkinson's Disease (PD). Nevertheless, there is limited evidence on the relationship between cognitive reserve and motor performance in complex situations in PD. To investigate the association between cognitive reserve and the dual-task gait effect in PD. Additionally, we examined the relationship between executive function, clinical and sociodemographic variables and, dual-task gait effects. We conducted a cross-sectional study with 44 PD participants. We evaluated dual-task effect on cadence, stride length, and gait velocity. Dual-task effects were correlated with neurophysiological factors, including cognitive reserve (Cognitive Reserve Index Questionnaire), overall cognitive performance of executive functions, a specific executive function domain (Trail Making Test), and the global cognitive status (Montreal Cognitive Assessment and Mini-Mental State Examination). Age, gender, and disease severity were considered as variables to be examined for correlation. We found that cognitive reserve did not influence gait performance under dual-task conditions in this sample. However, executive functions, age, and disease severity were associated with the dual-task effect on gait. The overall cognitive performance with respect to the Trail Making Test showed an inverse relationship in the dual-task gait effect on cadence. Our study's findings have important implications for understanding the association between executive functions, age, and disease severity with the dual-task effect on gait in PD. Pre-life factors, such as education, occupation, and leisure activity, did not contribute to coping with complex gait situations in PD.

摘要

更高的教育水平与帕金森病 (PD) 中运动障碍的严重程度呈负相关。然而,关于认知储备与 PD 复杂情况下运动表现之间的关系,证据有限。本研究旨在探讨认知储备与 PD 双重任务步态效应之间的关系。此外,我们还研究了执行功能、临床和社会人口统计学变量与双重任务步态效应之间的关系。我们进行了一项横断面研究,纳入了 44 名 PD 患者。我们评估了双重任务对步频、步长和步态速度的影响。双重任务效应与神经生理因素相关,包括认知储备(认知储备指数问卷)、执行功能的整体认知表现、特定执行功能领域(连线测试)和整体认知状态(蒙特利尔认知评估和简易精神状态检查)。年龄、性别和疾病严重程度被视为相关变量进行检查。结果发现,在本样本中,认知储备并不影响双重任务条件下的步态表现。然而,执行功能、年龄和疾病严重程度与 PD 患者的步态双重任务效应相关。整体认知表现与连线测试呈负相关,表明认知储备与步态速度呈负相关。本研究的结果对理解执行功能、年龄和疾病严重程度与 PD 步态双重任务效应之间的关系具有重要意义。生活前因素,如教育、职业和休闲活动,与 PD 中复杂步态情况的应对能力无关。

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