Abstract
Background.
Although dopaminergic medication improves dual task walking in people
with Parkinson disease (PD), the underlying neural mechanisms are not
yet fully understood. As prefrontal cognitive resources are involved in
dual task walking, evaluation of the prefrontal cortex (PFC) is
required. Objective.
To investigate the effect of dopaminergic
medication on PFC activity and gait parameters during dual task walking
in people with PD.
Methods.
A total of 20 individuals with PD
(69.8 ± 5.9 years) and 30 healthy older people (68.0 ± 5.6 years)
performed 2 walking conditions: single and dual task (walking while
performing a digit vigilance task). A mobile functional near infrared
spectroscopy system and an electronic sensor carpet were used to analyze
PFC activation and gait parameters, respectively. Relative
concentrations of oxygenated hemoglobin (HbO2) from the left and right PFC were measured.
Results.
People with PD in the off state did not present changes in HbO2 level in the left PFC across walking conditions. In contrast, in the on state, they presented increased HbO2 levels during dual task compared with single task. Regardless of medication state, people with PD presented increased HbO2
levels in the right PFC during dual task walking compared with single
task. The control group demonstrated increased PFC activity in both
hemispheres during dual task compared with single task. People with PD
showed increases in both step length and velocity in the on state
compared with the off state.
Conclusions.
PD limits the activation of the left PFC during dual task walking, and dopaminergic medication facilitates its recruitment.
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