Walking and Thinking - Brain Activity During Complex Walking in Aging and Parkinson's Disease

Completed

• Conditions: Gait Disorders, Neurologic; Parkinson Disease; Aging
• Interventions: Other: No intervention

• Registration Number: NCT05218213
• Lead Sponsor: Karolinska Institutet

Brief Summary

Every-day life means being part of a complex environment and performing complex tasks that usually involve a combination of motor and cognitive skills. However, the process of aging or the sequelae of neurological diseases such as Parkinson's disease (PD) compromises motor-cognitive interaction necessary for an independent lifestyle. While motor-cognitive performance has been identified as an important goal for sustained health across different clinical populations, little is known about underlying brain function leading to these difficulties and how to best target these motor-cognitive difficulties in the context of rehabilitation and exercise interventions.

The challenge of improving treatments of motor-cognitive difficulties (such as dual-tasking and navigation) is daunting, and an important step is arriving at a method that accurately portrays these impairments in an ecological valid state. The investigators aim therefore to explore brain function during complex walking in healthy and PD by investigating the effects of age and neurological disease on motor-cognitive performance and its neural correlates during three conditions of complex walking (dual-task walking, navigation and a combination of both) using non-invasive measures of brain activity (functional near infrared spectrometry, fNIRS) and advanced gait analysis in real time in young, older healthy adults and people with PD.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2021-12-21
• Study Start: 2022-01-21
• Study First Submitted QC: 2022-01-29
• Study First Posted: 2022-02-01
• Primary Completion: 2023-06-20
• Study Completion: 2023-06-28
• Status Verified: 2024-10
• Last Update Submitted: 2024-10-23
• Last Update Posted: 2024-10-24

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 133

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Parkinson's disease	No intervention	Elderly with Parkinson's disease
Healthy young	No intervention	Healthy young adults
Healthy elderly	No intervention	Healthy elderly adults

Primary Outcome Measures

Name	Time	Method
Gait performance during all conditions	During the test session during all three conditions	Gait variables such as stride time and/or velocity will be analyzed with the APDM mobility system.
Dual-task performance-reaction time	During the test session during dual task conditions	Cognitive performance of the dual task will be assessed as errors in the response to the Auditory stroop task.
Functional near infrared spectrometry (fNIRS)	During the test session during all three conditions	The measurement of changes in concentration of HbO and HHb in the prefrontal cortex will be assessed using a NIRSPORT 2 (NIRx Medizintechnik, Berlin, Germany) device

Secondary Outcome Measures

Name	Time	Method
Cognitive function- composite score	During the test session, takes about 50 minutes	The cognitive test battery comprised the following tests: The Color-Word Interference Test (CWIT), Verbal Fluency, Trail Making Test (TMT) and Ray Auditory Verbal Learning Test (RAVLT). Cognitive function will be assessed as a composite measure of these test together.
Cognitive function - Attention and psychomotor processing speed	During the test session, takes about 3 minutes	Attention and psychomotor processing speed will be assessed with the Trail Making Test (TMT) from D-KEFS (Delis-Kaplan Executive Function System)
Cognitive function - Episodic memory	During the test session, takes about 30 minutes	Episodic memory will be assessed with the Ray Auditory Verbal Learning Test (RAVLT).
Cognitive function - Inhibition & task-set switching	During the test session, takes about 5 minutes	Inhibition \& task-set switching with the The Color-Word Interference Test (CWIT) from D-KEFS (Delis-Kaplan Executive Function System)
Self-reported level of physical activity	Through study completion, an average of 1 year	Assessed with the Frändin-Grimby Scale (score 1-6, higher score=better)
Motor function/disease severity	During the test session	Assessed with the movement Disorders Society- Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Higher scores = worse/more symptoms
Cognitive function - verbal fluency	During the test session, takes about 12 minutes	Verbal function, initiation \& task-set switching with the Verbal Fluency test from D-KEFS (Delis-Kaplan Executive Function System)
Physical activity level and intensity	For one week after the test session	Assessed with accelerometers (Actigraph GT3X+)
Balance performance	During the test session	Assessed with the Mini-BESTest (Balance Evaluation Systems test), 0-28p,
Anxiety and depression	Will be answered before the test session in the patients home or during the test session	Assessed with Hospital Anxiety and Depression Scale (HADS), 0-24 on the depression and anxiety part respectively. Lower score=better
Walking ability	Will be answered before the test session in the patients home or at the test session	Self assessed walking ability with the WALK-12G
Dual-task performance -errors	During the test session during dual task conditions	Cognitive performance of the dual task will be assessed as the reaction time to respond during Auditory stroop
Disability	Will be answered before the test session in the patients home or during the test session	WHO Disability Assessment Schedule (WHODAS) version 2.0, 12 self-assessed questions (12 to 60) more points=worse

Trial Locations

Locations (1)

Karolinska institutet; 🇸🇪 Stockholm, Solna, Sweden