P30-S Impact of attentional abilities on step initiation in Parkinsonian patients with freezing of gait. Issue 7 (July 2019)

• Record Type: Journal Article
• Authors: Bayot, Madli; Braquet, Aurore; Tard, Céline; Defebvre, Luc; Dujardin, Kathy; Derambure, Philippe; Delval, Arnaud
• Is Part Of: Clinical neurophysiology. Volume 130:Issue 7(2019:Jul.)
• Page Start: e103
• Publication Date: 2019-07
• Subjects: Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2019.04.568
• Languages: English
• ISSNs: 1388-2457

Abstract

Abstract : Background: Components of visuospatial attention (alertness, orienting and executive control) have shown to be able to modulate specifically step initiation, and can be assessed simultaneously within a single paradigm: the "Attention Network Test" (ANT). However, patients with Parkinson's disease (PD) with freezing of gait (FoG) present a deficit in executive control that could deteriorate step initiation. The present study aims to a better understanding of the interaction between visuospatial attention and step initiation in PD patients with and without FoG through the observed modulation of (1) step initiation while performing the ANT and (2) cortical motor preparation. Material and methods: Fourteen freezers (PD + FoG), fifteen non-freezers (PD-FoG) and fifteen healthy controls (HC) performed an attentional task adapted from the ANT and combined with step initiation. Cortical activity during movement preparation (anticipatory postural adjustments, APAs) and step execution phase was assessed via high-resolution encephalography. Results: Although step execution time was longer for PD patients compared to HC partly due to a higher occurrence of multiple APAs, the effects of cue and target were not significantly different between groups. Subjects with PD presented abnormalities regarding movement-related desynchronization over the sensorimotor cortex after APA onset as a response to a target with incongruent flankers. Conclusions: Tasks with attentional load such as conflict resolution lead to an alteration of step initiation in the same way in PD + FoG, PD-FoG and HC. The concomittant EEG recording during the ANT combined with step initiation seems promising to better understand the influence of attention on gait initiation in PD.