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. 2022 Nov 30:14:1041378.
doi: 10.3389/fnagi.2022.1041378. eCollection 2022.

Dual-task walking improvement with enhanced kinesthetic awareness in Parkinson's disease with mild gait impairment: EEG connectivity and clinical implication

Cheng-Ya Huang  1   2 , Yu-An Chen  3 , Ruey-Meei Wu  4 , Ing-Shiou Hwang  5   6
Affiliations

Dual-task walking improvement with enhanced kinesthetic awareness in Parkinson's disease with mild gait impairment: EEG connectivity and clinical implication

Cheng-Ya Huang et al. Front Aging Neurosci. .

Abstract

Due to basal ganglia dysfunction, short step length is a common gait impairment in Parkinson's disease (PD), especially in a dual-task walking. Here, we use electroencephalography (EEG) functional connectivity to investigate neural mechanisms of a stride awareness strategy that could improve dual-task walking in PD. Eighteen individuals with PD who had mild gait impairment walked at self-paced speed while keeping two interlocking rings from touching each other. During the dual-task walking trial, the participants received or did not receive awareness instruction to take big steps. Gait parameters, ring-touching time, and EEG connectivity in the alpha and beta bands were analyzed. With stride awareness, individuals with PD exhibited greater gait velocity and step length, along with a significantly lower mean EEG connectivity strength in the beta band. The awareness-related changes in the EEG connectivity strength of the beta band positively correlated with the awareness-related changes in gait velocity, cadence, and step length, but negatively correlated with the awareness-related change in step-length variability. The smaller reduction in beta connectivity strength was associated with greater improvement in locomotion control with stride awareness. This study is the first to reveal that a stride awareness strategy modulates the beta band oscillatory network and is related to walking efficacy in individuals with PD in a dual-task condition.

Keywords: Parkinson’s disease; attention; beta oscillation; cortical connection; dual task; gait disorder.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Diagram of the experimental setup.
Figure 2
Figure 2
Contrast of population means in the PLI adjacent matrix in (A) alpha and (B) beta bands of all electrode pairs between the awareness strategy (AS) and non-awareness strategy (NAS) conditions. PLI, phase-lag index.
Figure 3
Figure 3
Adjacent matrices of p-values that contrast the PLI values of all electrode pairs between the AS and NAS conditions. A contrasting wiring diagram on the scalp shows the topological distributions of the above-threshold (p < 0.05) and supra-threshold connectivity (p < 0.005) in the beta band (13–35 Hz) tuned to stride awareness (NAS vs. AS). AS leads to widespread suppression of EEG beta connectivity in the fronto-centro-parietal-occipital areas. Dark blue line: AS < NAS, p < 0.005; light blue line: AS < NAS, p < 0.05; light red line: AS > NAS, p < 0.05. AS, awareness strategy; NAS, non-awareness strategy; PLI, phase-lag index.
Figure 4
Figure 4
Plots of significant correlations in awareness-related change in the m-PLI of the beta band and gait parameters. m-PLI, mean phase-lag index.
Figure 5
Figure 5
Schematic illustration of awareness-related changes in gait performance based on the U-shape relationship between system performance and the degree of beta synchrony.
See this image and copyright information in PMC

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