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- Title
Does Executive Function Influence Walking in Acutely Hospitalized Patients With Advanced Parkinson's Disease: A Quantitative Analysis.
- Authors
Geritz, Johanna; Welzel, Julius; Hansen, Clint; Maetzler, Corina; Hobert, Markus A.; Elshehabi, Morad; Sobczak, Alexandra; Kudelka, Jennifer; Stiel, Christopher; Hieke, Johanne; Alpes, Annekathrin; Bunzeck, Nico; Maetzler, Walter
- Abstract
Introduction: It is well-known that, in Parkinson's disease (PD), executive function (EF) andmotor deficits lead to reduced walking performance. As previous studies investigated mainly patients during the compensated phases of the disease, the aim of this study was to investigate the above associations in acutely hospitalized patients with PD. Methods: A total of seventy-four acutely hospitalized patients with PD were assessed with the delta Trail Making Test (1TMT, TMT-B minus TMT-A) and the Movement Disorder Society-revised version of the motor part of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS III). Walking performance was assessed with wearable sensors under single (ST; fast and normal pace) and dual-task (DT; walking and checking boxes as the motor secondary task and walking and subtracting seven consecutively from a given three-digit number as the cognitive secondary task) conditions over 20m. Multiple linear regression and Bayes factor BF10 were performed for each walking parameter and their dual-task costs while walking (DTC) as dependent variables and also included 1TMT, MDS-UPDRS III, age, and gender. Results: Under ST, significant negative effects of the use of a walking aid and MDSUPDRS III on gait speed and at a fast pace on the number of steps were observed. Moreover, depending on the pace, the use of a walking aid, age, and gender affected step time variability. Under walking-cognitive DT, a resolved variance of 23% was observed in the overall model for step time variability DTC, driven mainly by age (b = 0.26, p = 0.09). Under DT, no other significant effects could be observed. 1TMT showed no significant associations with any of the walking conditions. Discussion: The results of this study suggest that, in acutely hospitalized patients with PD, reduced walking performance is mainly explained by the use of a walking aid, motor symptoms, age, and gender, and EF deficits surprisingly do not seem to play a significant role. However, these patients with PD should avoid walking-cognitive DT situations, as under this condition, especially step time variability, a parameter associated with the risk of falling in PD worsens.
- Subjects
PARKINSON'S disease; EXECUTIVE function; HOSPITAL patients; TRAIL Making Test; WALKING speed
- Publication
Frontiers in Neurology, 2022, Vol 13, p1
- ISSN
1664-2295
- Publication type
Article
- DOI
10.3389/fneur.2022.852725