Abstract
Individuals with movement disorders (MD) have gait deficits including impaired automaticity and instability. Despite specific impairments in motor control networks, recent evidence suggests that cognitive deficits are common in individuals with MD and can magnify their gait problems. In this chapter, we present studies showing that locomotor difficulties among individuals with MD are mainly observed in those with cognitive deficits and during complex walking situations in which demands in cognitive and sensorimotor processing increase. Overall, studies demonstrate that gait disturbances and cognitive impairment coexist in MD and together accelerate the loss of mobility in these individuals.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Alves G, Forsaa EB, Pedersen KF, Dreetz Gjerstad M, Larsen JP. Epidemiology of Parkinson’s disease. J Neurol. 2008;255 Suppl 5:18–32.
Rajput AH, Birdi S. Epidemiology of Parkinson’s disease. Parkinsonism Relat Disord. 1997;3(4):175–86.
de Lau LM, Breteler MM. Epidemiology of Parkinson’s disease. Lancet Neurol. 2006;5(6):525–35.
Poldrack RA, Sabb FW, Foerde K, Tom SM, Asarnow RF, Bookheimer SY, et al. The neural correlates of motor skill automaticity. J Neurosci. 2005;25(22):5356–64.
Morris ME, Iansek R, Matyas TA, Summers JJ. The pathogenesis of gait hypokinesia in Parkinson’s disease. Brain. 1994;117(Pt 5):1169–81.
Morris ME, Iansek R, Matyas TA, Summers JJ. Stride length regulation in Parkinson’s disease. Normalization strategies and underlying mechanisms. Brain. 1996;119(Pt 2):551–68.
Rochester L, Baker K, Nieuwboer A, Burn D. Targeting dopa-sensitive and dopa-resistant gait dysfunction in Parkinson’s disease: selective responses to internal and external cues. Mov Disord. 2011;26(3):430–5.
Hausdorff JM, Balash J, Giladi N. Effects of cognitive challenge on gait variability in patients with Parkinson’s disease. J Geriatr Psychiatry Neurol. 2003;16(1):53–8.
Yogev G, Giladi N, Peretz C, Springer S, Simon ES, Hausdorff JM. Dual tasking, gait rhythmicity, and Parkinson’s disease: which aspects of gait are attention demanding? Eur J Neurosci. 2005;22(5):1248–56.
Baker K, Rochester L, Nieuwboer A. The immediate effect of attentional, auditory, and a combined cue strategy on gait during single and dual tasks in Parkinson’s disease. Arch Phys Med Rehabil. 2007;88(12):1593–600.
Rochester L, Hetherington V, Jones D, Nieuwboer A, Willems AM, Kwakkel G, et al. Attending to the task: interference effects of functional tasks on walking in Parkinson’s disease and the roles of cognition, depression, fatigue, and balance. Arch Phys Med Rehabil. 2004;85(10):1578–85.
Rochester L, Hetherington V, Jones D, Nieuwboer A, Willems AM, Kwakkel G, et al. The effect of external rhythmic cues (auditory and visual) on walking during a functional task in homes of people with Parkinson’s disease. Arch Phys Med Rehabil. 2005;86(5):999–1006.
Bond JM, Morris M. Goal-directed secondary motor tasks: their effects on gait in subjects with Parkinson disease. Arch Phys Med Rehabil. 2000;81(1):110–6.
O’Shea S, Morris ME, Iansek R. Dual task interference during gait in people with Parkinson disease: effects of motor versus cognitive secondary tasks. Phys Ther. 2002;82(9):888–97.
Aarsland D, Bronnick K, Williams-Gray C, Weintraub D, Marder K, Kulisevsky J, et al. Mild cognitive impairment in Parkinson disease: a multicenter pooled analysis. Neurology. 2010;75(12):1062–9.
Williams-Gray CH, Mason SL, Evans JR, Foltynie T, Brayne C, Robbins TW, et al. The CamPaIGN study of Parkinson’s disease: 10-year outlook in an incident population-based cohort. J Neurol Neurosurg Psychiatry. 2013;84(11):1258–64.
Burn DJ, Rowan EN, Allan LM, Molloy S, O’Brien JT, McKeith IG. Motor subtype and cognitive decline in Parkinson’s disease, Parkinson’s disease with dementia, and dementia with Lewy bodies. J Neurol Neurosurg Psychiatry. 2006;77(5):585–9.
Lord S, Rochester L, Hetherington V, Allcock LM, Burn D. Executive dysfunction and attention contribute to gait interference in ‘off’ state Parkinson’s Disease. Gait Posture. 2010;31(2):169–74.
Montero-Odasso M, Oteng-Amoako A, Speechley M, Gopaul K, Beauchet O, Annweiler C, et al. The motor signature of mild cognitive impairment: results from the gait and brain study. J Gerontol A Biol Sci Med Sci. 2014;69(11):1415–21.
Miyake A, Friedman NP, Emerson MJ, Witzki AH, Howerter A, Wager TD. The unity and diversity of executive functions and their contributions to complex “Frontal Lobe” tasks: a latent variable analysis. Cogn Psychol. 2000;41(1):49–100.
Springer S, Giladi N, Peretz C, Yogev G, Simon ES, Hausdorff JM. Dual-tasking effects on gait variability: the role of aging, falls, and executive function. Mov Disord. 2006;21(7):950–7.
Giladi N, Kao R, Fahn S. Freezing phenomenon in patients with parkinsonian syndromes. Mov Disord. 1997;12(3):302–5.
Giladi N. Freezing of gait. Clin overview Adv Neurol. 2001;87:191–7.
Nutt JG, Bloem BR, Giladi N, Hallett M, Horak FB, Nieuwboer A. Freezing of gait: moving forward on a mysterious clinical phenomenon. Lancet Neurol. 2011;10(8):734–44.
Shine JM, Matar E, Ward PB, Bolitho SJ, Gilat M, Pearson M, et al. Exploring the cortical and subcortical functional magnetic resonance imaging changes associated with freezing in Parkinson’s disease. Brain. 2013;136(Pt 4):1204–15.
Vandenbossche J, Deroost N, Soetens E, Spildooren J, Vercruysse S, Nieuwboer A, et al. Freezing of gait in Parkinson disease is associated with impaired conflict resolution. Neurorehabil Neural Repair. 2011;25(8):765–73.
Plotnik M, Giladi N, Balash Y, Peretz C, Hausdorff JM. Is freezing of gait in Parkinson’s disease related to asymmetric motor function? Ann Neurol. 2005;57(5):656–63.
Almeida QJ, Lebold CA. Freezing of gait in Parkinson’s disease: a perceptual cause for a motor impairment? J Neurol Neurosurg Psychiatry. 2010;81(5):513–8.
Silveira CRA, Ehgoetz Martens KA, Pieruccini-Faria F, Bell-Boucher D, Roy EA, Almeida QJ. Disentangling perceptual judgment and online feedback deficits in Parkinson’s freezing of gait. J Neurol. 2015;262(7):1629–36.
Ehgoetz Martens KA, Pieruccini-Faria F, Almeida QJ. Could sensory mechanisms be a core factor that underlies freezing of gait in Parkinson’s disease? PLoS One. 2013;8(5), e62602.
Chee R, Murphy A, Danoudis M, Georgiou-Karistianis N, Iansek R. Gait freezing in Parkinson’s disease and the stride length sequence effect interaction. Brain. 2009;132:2151–60.
Pieruccini-Faria F, Jones JA, Almeida QJ. Motor planning in Parkinson’s disease patients experiencing freezing of gait: the influence of cognitive load when approaching obstacles. Brain Cogn. 2014;87:76–85. Epub 2014/04/15.
Knobl P, Kielstra L, Almeida Q. The relationship between motor planning and freezing of gait in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2012;83(1):98–101.
Pieruccini-Faria F, Ehgoetz Martens KA, Silveira CRA, Jones JA, Almeida QJ. Side of basal ganglia degeneration influences freezing of gait in Parkinson’s disease. Behav Neurosci. 2015;29(2):214–8.
Fling BW, Cohen RG, Mancini M, Nutt JG, Fair DA, Horak FB. Asymmetric pedunculopontine network connectivity in parkinsonian patients with freezing of gait. Brain. 2013;136(Pt 8):2405–18.
Lieberman A. Are freezing of gait (FOG) and panic related? J Neurol Sci. 2006;248(1-2):219–22.
Ehgoetz Martens KA, Ellard CG, Almeida QJ. Does anxiety cause freezing of gait in Parkinson’s disease? PLoS One. 2014;9(9), e106561.
Hausdorff JM, Schaafsma JD, Balash Y, Bartels AL, Gurevich T, Giladi N. Impaired regulation of stride variability in Parkinson’s disease subjects with freezing of gait. Exp Brain Res. 2003;149(2):187–94.
Nieuwboer A, Dom R, De Weerdt W, Desloovere K, Janssens L, Stijn V. Electromyographic profiles of gait prior to onset of freezing episodes in patients with Parkinson’s disease. Brain. 2004;127(Pt 7):1650–60.
Bhatt H, Pieruccini-Faria F, Almeida QJ. Dynamics of turning sharpness influences freezing of gait in Parkinson’s disease. Parkinsonism Relat Disord. 2013;19(2):181–5.
Spildooren J, Vercruysse S, Desloovere K, Vandenberghe W, Kerckhofs E, Nieuwboer A. Freezing of gait in Parkinson’s disease: the impact of dual-tasking and turning. Mov Disord. 2010;25(15):2563–70.
Naismith SL, Shine JM, Lewis SJ. The specific contributions of set-shifting to freezing of gait in Parkinson’s disease. Mov Disord. 2010;25(8):1000–4.
Pahapill PA, Lozano AM. The pedunculopontine nucleus and Parkinson’s disease. Brain. 2000;123(Pt 9):1767–83.
Pieruccini-Faria F, Jones JA, Almeida QJ. Insight into dopamine-dependent planning deficits in Parkinson’s disease: a sharing of cognitive & sensory resources. Neuroscience. 2016;318:219–29.
Pieruccini-Faria F, Vitorio R, Almeida QJ, Silveira CRA, Caetano MJ, Stella F, et al. Evaluating the acute contributions of dopaminergic replacement to gait with obstacles in Parkinson’s disease. J Mot Behav. 2013;45(5):369–80.
Pieruccini-Faria F, Ehgoetz Martens KA, Silveira CRA, Jones JA, Almeida QJ. Interactions between cognitive and sensory load while planning and controlling complex gait adaptations in Parkinson’s disease. BMC Neurol. 2014;14(1):250.
Redgrave P, Rodriguez M, Smith Y, Rodriguez-Oroz MC, Lehericy S, Bergman H, et al. Goal-directed and habitual control in the basal ganglia: implications for Parkinson’s disease. Nat Rev Neurosci. 2010;11(11):760–72.
Sage MD, Almeida QJ. Symptom and gait changes after sensory attention focused exercise vs aerobic training in Parkinson’s disease. Mov Disord. 2009;24(8):1132–8.
Maidan I, Bernad-Elazari H, Gazit E, Giladi N, Hausdorff JM, Mirelman A. Changes in oxygenated hemoglobin link freezing of gait to frontal activation in patients with Parkinson disease: an fNIRS study of transient motor-cognitive failures. J Neurol. 2015.
Gazibara T, Pekmezovic T, Tepavcevic DK, Tomic A, Stankovic I, Kostic VS, et al. Circumstances of falls and fall-related injuries among patients with Parkinson’s disease in an outpatient setting. Geriatr Nurs. 2014;35(5):364–9.
Grimbergen YA, Munneke M, Bloem BR. Falls in Parkinson’s disease. Curr Opin Neurol. 2004;17(4):405–15.
Amboni M, Barone P, Hausdorff JM. Cognitive contributions to gait and falls: evidence and implications. Mov Disord. 2013;28(11):1520–33.
Camicioli R, Majumdar SR. Relationship between mild cognitive impairment and falls in older people with and without Parkinson’s disease: 1-Year Prospective Cohort Study. Gait Posture. 2010;32(1):87–91.
Hausdorff JM, Doniger GM, Springer S, Yogev G, Simon ES, Giladi N. A common cognitive profile in elderly fallers and in patients with Parkinson’s disease: the prominence of impaired executive function and attention. Exp Aging Res. 2006;32(4):411–29.
Yogev G, Plotnik M, Peretz C, Giladi N, Hausdorff JM. Gait asymmetry in patients with Parkinson’s disease and elderly fallers: when does the bilateral coordination of gait require attention? Exp Brain Res. 2007;177(3):336–46.
Amboni M, Barone P, Iuppariello L, Lista I, Tranfaglia R, Fasano A, et al. Gait patterns in Parkinsonian patients with or without mild cognitive impairment. Mov Disord. 2012;27(12):1536–43.
Bohnen NI, Muller ML, Koeppe RA, Studenski SA, Kilbourn MA, Frey KA, et al. History of falls in Parkinson disease is associated with reduced cholinergic activity. Neurology. 2009;73(20):1670–6.
Blin O, Ferrandez AM, Pailhous J, Serratrice G. Dopa-sensitive and dopa-resistant gait parameters in Parkinson’s disease. J Neurol Sci. 1991;103(1):51–4.
Lord S, Baker K, Nieuwboer A, Burn D, Rochester L. Gait variability in Parkinson’s disease: an indicator of non-dopaminergic contributors to gait dysfunction? J Neurol. 2011;258(4):566–72.
Sarter M, Albin RL, Kucinski A, Lustig C. Where attention falls: increased risk of falls from the converging impact of cortical cholinergic and midbrain dopamine loss on striatal function. Exp Neurol. 2014;257:120–9.
Goble DJ, Coxon JP, Van Impe A, Geurts M, Van Hecke W, Sunaert S, et al. The neural basis of central proprioceptive processing in older versus younger adults: an important sensory role for right putamen. Hum Brain Mapp. 2012;33(4):895–908.
Lewis SJ, Dove A, Robbins TW, Barker RA, Owen AM. Striatal contributions to working memory: a functional magnetic resonance imaging study in humans. Eur J Neurosci. 2004;19(3):755–60. Epub 2004/02/27.
Koller WC, Trimble J. The gait abnormality of Huntington’s disease. Neurology. 1985;35(10):1450–4.
Brandt J, Folstein SE, Folstein MF. Differential cognitive impairment in Alzheimer’s disease and Huntington’s disease. Ann Neurol. 1988;23(6):555–61.
Lawrence AD, Sahakian BJ, Robbins TW. Cognitive functions and corticostriatal circuits: insights from Huntington’s disease. Trends Cogn Sci. 1998;2(10):379–88.
Delval A, Krystkowiak P, Delliaux M, Dujardin K, Blatt JL, Destee A, et al. Role of attentional resources on gait performance in Huntington’s disease. Mov Disord. 2008;23(5):684–9.
Thaut MH, Miltner R, Lange HW, Hurt CP, Hoemberg V. Velocity modulation and rhythmic synchronization of gait in Huntington’s disease. Mov Disord. 1999;14(5):808–19.
Esterhammer R, Schocke M, Seppi K. Basal ganglia cellular pathology in multiple system atrophy, progressive supranuclear palsy and Parkinson disease. Can quantitative magnetic resonance spectroscopic imaging make the difference? Eur J Neurol. 2010;17(9):1111–2.
Piao YS, Hayashi S, Wakabayashi K, Kakita A, Aida I, Yamada M, et al. Cerebellar cortical tau pathology in progressive supranuclear palsy and corticobasal degeneration. Acta Neuropathol. 2002;103(5):469–74.
Ghatak NR, Nochlin D, Hadfield MG. Neurofibrillary pathology in progressive supranuclear palsy. Acta Neuropathol. 1980;52(1):73–6.
Kim SL, Lee MJ, Lee MS. Cognitive dysfunction associated with falls in progressive supranuclear palsy. Gait Posture. 2014;40(4):605–9.
Egerton T, Williams DR, Iansek R. Comparison of gait in progressive supranuclear palsy Parkinson’s disease and healthy older adults. BMC Neurol. 2012;12:116.
Burrell JR, Hodges JR, Rowe JB. Cognition in corticobasal syndrome and progressive supranuclear palsy: a review. Mov Disord. 2014;29(5):684–93.
Grafman J, Litvan I, Stark M. Neuropsychological features of progressive supranuclear palsy. Brain Cogn. 1995;28(3):311–20.
Robbins TW, James M, Owen AM, Lange KW, Lees AJ, Leigh PN, et al. Cognitive deficits in progressive supranuclear palsy, Parkinson’s disease, and multiple system atrophy in tests sensitive to frontal lobe dysfunction. J Neurol Neurosurg Psychiatry. 1994;57(1):79–88.
Lindemann U, Nicolai S, Beische D, Becker C, Srulijes K, Dietzel E, et al. Clinical and dual-tasking aspects in frequent and infrequent fallers with progressive supranuclear palsy. Mov Disord. 2010;25(8):1040–6.
Acknowledgment
This work was supported in part by the National Council for Scientific and Technological Development, Brazil (CNPq), as scholarship to FPF and CRAS.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Pieruccini-Faria, F., Silveira, C.R.A., Almeida, Q.J. (2017). Gait Disturbances in Movement Disorders: A Motor-Cognitive Problem. In: Barbieri, F., Vitório, R. (eds) Locomotion and Posture in Older Adults. Springer, Cham. https://doi.org/10.1007/978-3-319-48980-3_9
Download citation
DOI: https://doi.org/10.1007/978-3-319-48980-3_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-48979-7
Online ISBN: 978-3-319-48980-3
eBook Packages: MedicineMedicine (R0)