Abstract

In Parkinson’s disease (PD), impaired gait and cognition affect daily activities, particularly in the more advanced stages of the disease. This study investigated the relationship between gait parameters, cognitive performance, and brain morphology in patients with early untreated PD. 64 drug-naive PD patients and 47 healthy controls (HC) participated in the study. Single- and dual-task gait (counting task) were examined using an expanded Timed Up & Go Test measured on a GaitRite walkway. Measurements included gait speed, stride length, and cadence. A brain morphometry analysis was performed on T1-weighted magnetic resonance (MR) images. In PD patients compared to HC, gait analysis revealed reduced speed (p < 0.001) and stride length (p < 0.001) in single-task gait, as well as greater dual-task cost (DTC) for speed (p = 0.007), stride length (p = 0.014) and cadence (p = 0.029). Based on the DTC measures in HC, PD patients were further divided into two subgroups with normal DTC (PD-nDTC) and abnormally increased DTC (PD-iDTC). For PD-nDTC, voxel-based morphometric correlation analysis revealed a positive correlation between a cluster in the left primary motor cortex and stride-length DTC (r = 0.57, p = 0.027). For PD-iDTC, a negative correlation was found between a cluster in the right lingual gyrus and the DTC for gait cadence (r=-0.35, p_FWE = 0.018). No significant correlations were found in HC. The associations found between brain morphometry and gait performance with a concurrent cognitive task may represent the substrate for gait and cognitive impairment occurring since the early stages of PD.

中文翻译：

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帕金森病的双任务步态受损与大脑形态变化有关

摘要

在帕金森病 (PD) 中，步态和认知受损会影响日常活动，尤其是在疾病晚期。本研究调查了未经治疗的早期帕金森病患者的步态参数、认知表现和大脑形态之间的关系。64 名未接受药物治疗的 PD 患者和 47 名健康对照者 (HC) 参与了该研究。使用在 GaitRite 走道上测量的扩展 Timed Up & Go 测试来检查单任务步态和双任务步态（计数任务）。测量包括步态速度、步幅和步频。对 T1 加权磁共振 (MR) 图像进行脑形态测量分析。与 HC 相比，PD 患者的步态分析显示单任务步态的速度 ( p  < 0.001) 和步幅长度 ( p  < 0.001) 降低，并且双任务速度成本 (DTC) 更大 ( p  = 0.007)，步幅 ( p  = 0.014) 和步频 ( p  = 0.029)。根据 HC 中的 DTC 测量值，PD 患者进一步分为 DTC 正常 (PD-nDTC) 和 DTC 异常升高 (PD-iDTC) 两个亚组。对于 PD-nDTC，基于体素的形态相关分析显示，左侧初级运动皮层中的簇与步长 DTC 之间存在正相关性（r  = 0.57，p  = 0.027）。对于 PD-iDTC，发现右侧舌回簇与步态节奏 DTC 之间呈负相关（r =-0.35，p _FWE = 0.018）。HC 中未发现显着相关性。大脑形态测量和步态表现与并发认知任务之间的关联可能代表了自 PD 早期阶段以来发生的步态和认知障碍的基础。